Individual provider Active NPI

Don Dequine Jr., PT

  • Physical Therapist
  • Shawnee, KS
National Provider Identifier
1871984161
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-05003 Issued in KS
Practice address
7740 Hedge Lane Ter
Shawnee, KS 66227-3017
Phone
(913) 745-7537
NPI assigned
Feb 9, 2015
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-05003 KS Primary

Addresses

Primary practice location

7740 Hedge Lane Ter
Shawnee, KS 66227-3017

Mailing address

7740 Hedge Lane Ter
Shawnee, KS 66227-3017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150410002513 KS Practitioner - Physical Therapist in Private Practice 2062730682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Physical Therapy and Training Center PA Physical Therapist CurrentSince Apr 1, 2015 Accepting new patients
Spectrum Private Care Services, LLC PastSince Dec 26, 2021 Accepting new patients

Locations

7732 Hedge Lane Ter
Shawnee, KS 66227
Phone (913) 299-7100

7740 Hedge Lane Ter
Shawnee, KS 66227
Phone (913) 745-7537

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1871984161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 HEDGE LANE TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662273017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 HEDGE LANE TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662273017",
            "telephone_number": "913-745-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEQUINE",
        "first_name": "DON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-05003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.

Verify at the official NPI Registry.