Individual provider Active NPI

Dale Theodore Bussell, P.T.

  • Physical Therapist
  • Huron, SD
National Provider Identifier
1043413701
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0031 Issued in SD
Practice address
530 Iowa Ave SE
Ste.105
Huron, SD 57350-2864
Phone
(605) 352-2169
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0031 SD Primary

Addresses

Primary practice location

530 Iowa Ave SE
Ste.105
Huron, SD 57350-2864

Mailing address

5000 E Grant Rd
Unit #6
Tucson, AZ 85712-2749
Phone (520) 512-1038

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

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Physical Therapy Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043413701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 E GRANT RD",
            "address_2": "UNIT #6",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122749",
            "telephone_number": "520-512-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 IOWA AVE SE",
            "address_2": "STE.105",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502864",
            "telephone_number": "605-352-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSELL",
        "first_name": "DALE",
        "middle_name": "THEODORE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "0031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huron, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.