Alyssa Dickman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA011117 Issued in OH

Practice address

1310 Chestnut St
Fremont, OH 43420

Phone

(419) 307-5976

NPI assigned

Dec 29, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1033574587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CHESTNUT ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434204316",
            "telephone_number": "419-307-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CHESTNUT ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "43420",
            "telephone_number": "419-307-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "ALYSSA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "9369A",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA011117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Desrosiers
• Kimberly Ann Dewalt
• Daniel George Dewood
• Dialysis Centers of Northwest Ohio, LTD. (U.S. Renal Care Fremont Dialysis)
• Gerardo Diaz, QMHS
• Jonathan F. Diller, M.D.
• Marissa Kay Dingledine, CDCA
• Abigail Doster
• Douglas R Bowman DDS LLC
• Dr Daniel Kelderhouse Inc

• Physical Therapy Assistant in Fremont, OH
• Providers in Fremont, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.