Active NPI
Dustin Michael Farris, PT
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1013636760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05014757A
- Practice address
- 7855 S Emerson Ave Ste W
Indianapolis, IN 46237-8669 - Phone
- (317) 889-5340
- Fax
- (317) 889-5711
- NPI assigned
- Aug 25, 2022
- 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 | 05014757A | IN | Primary |
Addresses
Primary practice location
7855 S Emerson Ave Ste W
Indianapolis, IN 46237-8669
Mailing address
4251 Lahmeyer Rd
Fort Wayne, IN 46815-5676
Phone (260) 432-4700
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 |
|---|---|---|---|
| 05014757A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1013636760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4251 LAHMEYER RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468155676",
"telephone_number": "260-432-4700",
"fax_number": "260-459-9262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7855 S EMERSON AVE STE W",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462378669",
"telephone_number": "317-889-5340",
"fax_number": "317-889-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRIS",
"first_name": "DUSTIN",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-25",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05014757A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.