Angela Kaye Moore Tanaka, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2022 Issued in ID

Practice address

352 E Riverside Dr Ste A6
St George, UT 84790-6999

Phone

(204) 355-7934

Fax

(435) 213-2691

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dynamic Physical Therapy & Wellness LLC

  • Physical Therapist
  • St George, UT
  • NPI 1942894316
  Medicare reassignment NPD Authorized official
• TRSR, PLLC

  • Chiropractor
  • West Richland, WA
  • NPI 1326362542
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1053498543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3068 SWAPS DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907468",
            "telephone_number": "435-579-3494",
            "fax_number": "435-213-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 E RIVERSIDE DR STE A6",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847906999",
            "telephone_number": "204-355-7934",
            "fax_number": "435-213-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "ANGELA",
        "middle_name": "KAYE MOORE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Talbot
• Teresa Talbot
• Tia Marie Talbot, APRN
• Wendy Finlinson Talbot
• Denver Talley
• Alma Dinora Tanner
• Skyler Tarver
• Kera Tasker
• Cami Jo Tate
• Charles W Tate III, M.D.

• Physical Therapist in St George, UT
• Providers in St George, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.