Douglas P Kavanaugh, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1837 Issued in NE

Practice address

4451 N 26TH St
Suite 1000
Lincoln, NE 68521-4142

Phone

(402) 476-2600

Fax

(402) 476-2604

NPI assigned

Jan 5, 2007

Sex

Male

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

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Nebraska College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lincoln Physical Therapy and Sports Rehab LLCGroup PAC ID 9133438641, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lincoln Physical Therapy and Sports Rehab LLC

  • Physical Therapist
  • Lincoln, NE
  • NPI 1679783963
  Medicare reassignment Care Compare group
• Lincoln Physical Therapy and Sports Rehab LLC

  • Physical Therapist
  • Georgetown, TX
  • NPI 1881347623
  NPD
• Lincoln Physical Therapy and Sports Rehab LLC

  • Physical Therapist
  • Lincoln, NE
  • NPI 1891846572
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1871640326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4451 N 26TH ST",
            "address_2": "SUITE 1000",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214142",
            "telephone_number": "402-476-2600",
            "fax_number": "402-476-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 N 26TH ST",
            "address_2": "SUITE 1000",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214142",
            "telephone_number": "402-476-2600",
            "fax_number": "402-476-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "DOUGLAS",
        "middle_name": "P",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Kaup, MA, LMHP, CPC
• Mary Kaup, CRNA
• Mitchell Ryan Kaus, DDS
• Becky Kavan
• Mylnn Kavan
• Kacie Kavanaugh
• Tiffany M. Kavanaugh, LCSW
• Kimberly M Kaven, PHARMD
• Kavonne Crockett
• Ta Kaw

• Physical Therapist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.