Active NPI
Jacob K Fanning, DPT
- Physical Therapist
- Columbus, OH
National Provider Identifier
1992045025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 014126
- Practice address
- 2476 Powell Ave
Columbus, OH 43209-1749 - Phone
- (419) 573-9701
- NPI assigned
- Feb 27, 2013
- 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 Therapist | 225100000X | 014126 | OH | Primary |
Addresses
Primary practice location
2476 Powell Ave
Columbus, OH 43209-1749
Mailing address
2476 Powell Ave
Columbus, OH 43209-1749
Phone (419) 573-9701
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 |
|---|---|---|---|
| 014126 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1992045025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2476 POWELL AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432091749",
"telephone_number": "419-573-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2476 POWELL AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432091749",
"telephone_number": "419-573-9701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNING",
"first_name": "JACOB",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-27",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "014126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.