Individual provider Active NPI

Dan McClellan

  • Physical Therapist
  • Farmington, NM
National Provider Identifier
1881064475
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4696 Issued in NM
Practice address
5608 Fairway Dr
Farmington, NM 87402-5027
Phone
(505) 459-3788
NPI assigned
Sep 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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 4696 NM Primary

Addresses

Primary practice location

5608 Fairway Dr
Farmington, NM 87402-5027

Mailing address

5608 Fairway Dr
Farmington, NM 87402-5027
Phone (505) 459-3788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211000211 NM Practitioner - Physical Therapist in Private Practice 3274027867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

904 E 20TH St
Suite a
Farmington, NM 87401-4281
Phone (505) 609-8424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4696NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McClellan Therapy PC Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Patient Centered Health, LLC Past Accepting new patients

Locations

904 E 20th St
Ste A
Farmington, NM 87401
Phone (505) 325-2010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1881064475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 FAIRWAY DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025027",
            "telephone_number": "505-459-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5608 FAIRWAY DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025027",
            "telephone_number": "505-459-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "DAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-25",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.