Active NPI
Antran T McDaniel, PTA
- Physical Therapy Assistant
- Supply, NC
National Provider Identifier
1831822683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A5033
- Practice address
- 1163 Dobson St SW
Supply, NC 28462-3208 - Phone
- (843) 655-8608
- NPI assigned
- Jul 7, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A5033 | NC | Primary |
Addresses
Primary practice location
1163 Dobson St SW
Supply, NC 28462-3208
Mailing address
1163 Dobson St SW
Supply, NC 28462-3208
Phone (843) 655-8608
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A5033 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657152000000",
"number": "1831822683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1163 DOBSON ST SW",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284623208",
"telephone_number": "843-655-8608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1163 DOBSON ST SW",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284623208",
"telephone_number": "843-655-8608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "ANTRAN",
"middle_name": "T",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-07",
"last_updated": "2022-07-07",
"certification_date": "2022-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A5033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Supply, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.