Active NPI
Madison Dallenbach, OTR/L
- Occupational Therapist
- Tuscaloosa, AL
National Provider Identifier
1063296705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6149
- Practice address
- 2703 University Blvd E
Tuscaloosa, AL 35404-3226 - Phone
- (205) 248-7064
- Fax
- (205) 523-7158
- NPI assigned
- Aug 23, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6149 | AL | Primary |
Addresses
Primary practice location
2703 University Blvd E
Tuscaloosa, AL 35404-3226
Mailing address
119 Wexford Way
Tuscaloosa, AL 35405-6131
Phone (918) 740-5280
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1063296705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 WEXFORD WAY",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354056131",
"telephone_number": "918-740-5280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2703 UNIVERSITY BLVD E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354043226",
"telephone_number": "205-248-7064",
"fax_number": "205-523-7158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLENBACH",
"first_name": "MADISON",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-23",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "6149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.