Active NPI
Dalton Tice, ATC, EMT, CFT
- Athletic Trainer
- Reading, PA
National Provider Identifier
1013315761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT005694
- Practice address
- 4901 Green Tree Rd
Reading, PA 19606-3340 - Phone
- (610) 914-6463
- NPI assigned
- Dec 11, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT005694 | PA | Primary |
| Athletic Trainer | 2255A2300X | 0598 | NH | |
| Basic Emergency Medical Technician | 146N00000X | 186907 | PA |
Addresses
Primary practice location
4901 Green Tree Rd
Reading, PA 19606-3340
Mailing address
4901 Green Tree Rd
Reading, PA 19606-3340
Phone (610) 914-6463
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
- Credentials
- Emergency Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 186907 | PA | MD | Basic Emergency Medical Technician |
| 0598 | NH | MD | Athletic Trainer |
| RT005694 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418256000000",
"number": "1013315761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4901 GREEN TREE RD",
"city": "READING",
"state": "PA",
"postal_code": "196063340",
"telephone_number": "610-914-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 GREEN TREE RD",
"city": "READING",
"state": "PA",
"postal_code": "196063340",
"telephone_number": "610-914-6463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TICE",
"first_name": "DALTON",
"name_prefix": "Mr.",
"credential": "ATC, EMT, CFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-11",
"last_updated": "2014-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT005694",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NH",
"license": "0598",
"primary": false
},
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "PA",
"license": "186907",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reading, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.