Active NPI
Dianne Margaret Kanakkanatt, PT
- Physical Therapist
- Worthington, OH
National Provider Identifier
1720040561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014914
- Practice address
- 350 W Wilson Bridge Rd Ste 200
Worthington, OH 43085-2591 - Phone
- (614) 895-8747
- Fax
- (614) 895-8810
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT014914 | OH | Primary |
| Physical Therapist | 225100000X | 2305202544 | VA |
Addresses
Primary practice location
350 W Wilson Bridge Rd Ste 200
Worthington, OH 43085-2591
Mailing address
6480 Harrison Ave Ste 201
Cincinnati, OH 45247-7961
Phone (513) 713-1779
Other names 1
- Dianne Margaret Shineman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8064 | MN | MD | Clinical Social Worker |
| 2305202544 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohrh, LLC | Current | Accepting new patients | |
| Ohrh, LLC | Physical Therapist | Current | Accepting new patients |
Locations
720 E Broad St
Columbus, OH 43215
Phone (614) 224-1090
6021 Cleveland Ave
Columbus, OH 43231
Phone (614) 224-1090
Interoperability endpoints
- dianne.kanakkanatt.p1@direct.beaconortho.nextgenshare.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Grove City, OH
- NPI 1770060212
-
dba NovaCare Rehabilitation
- Physical Therapy Clinic/Center
- Chillicothe, OH
- NPI 1265140917
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1720040561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6480 HARRISON AVE STE 201",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452477961",
"telephone_number": "513-713-1779",
"fax_number": "513-854-9921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 W WILSON BRIDGE RD STE 200",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852591",
"telephone_number": "614-895-8747",
"fax_number": "614-895-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANAKKANATT",
"first_name": "DIANNE",
"middle_name": "MARGARET",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT014914",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305202544",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANNE",
"last_name": "SHINEMAN",
"middle_name": "MARGARET",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.