Active NPI
Michael R Mahan, PT
- Physical Therapist
- Vandalia, OH
National Provider Identifier
1942500608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT001700
- Practice address
- 830 Falls Creek Dr.
Vandalia, OH 45377-9415 - Phone
- (937) 890-9235
- Fax
- (937) 890-9239
- NPI assigned
- Oct 28, 2010
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | PT001700 | OH | Primary |
Addresses
Primary practice location
830 Falls Creek Dr.
Vandalia, OH 45377-9415
Mailing address
830 Falls Creek Dr.
Vandalia, OH 45377-9415
Phone (937) 890-9235
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT001700 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Xcel Sports Medicine LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Vandalia, OH
- NPI 1730127341
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1942500608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 FALLS CREEK DR.",
"city": "VANDALIA",
"state": "OH",
"postal_code": "453779415",
"telephone_number": "937-890-9235",
"fax_number": "937-890-9239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 FALLS CREEK DR.",
"city": "VANDALIA",
"state": "OH",
"postal_code": "453779415",
"telephone_number": "937-890-9235",
"fax_number": "937-890-9239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAN",
"first_name": "MICHAEL",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-28",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT001700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vandalia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.