McKenna R Gleason, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT303641 Issued in CA

Practice address

100 N Barranca St Ste 920
West Covina, CA 91791-1654

Phone

(626) 263-6469

NPI assigned

Mar 30, 2023

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1740984863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN STE 103",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083238",
            "telephone_number": "909-567-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 920",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911654",
            "telephone_number": "626-263-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "MCKENNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT303641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in West Covina, CA
• Providers in West Covina, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.