Active NPI
Jodi Lynn Dorage, PTA
- Physical Therapy Assistant
- Manson, IA
National Provider Identifier
1013158682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 00126
- Practice address
- 1402 Main St
Manson, IA 50563-5160 - Phone
- (712) 469-3908
- NPI assigned
- Mar 11, 2009
- Sex
- Female
- 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 Therapy Assistant | 225200000X | 00126 | IA | Primary |
Addresses
Primary practice location
1402 Main St
Manson, IA 50563-5160
Mailing address
847 14TH Ave
PO Box 804
Manson, IA 50563-7729
Phone (712) 469-3523
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00126 | IA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236729600000",
"number": "1013158682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 14TH AVE",
"address_2": "PO BOX 804",
"city": "MANSON",
"state": "IA",
"postal_code": "505637729",
"telephone_number": "712-469-3523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 MAIN ST",
"city": "MANSON",
"state": "IA",
"postal_code": "505635160",
"telephone_number": "712-469-3908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORAGE",
"first_name": "JODI",
"middle_name": "LYNN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-11",
"last_updated": "2009-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "00126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manson, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.