NPIMap

Organization Active NPI

DPT Inc

  • Physical Therapy Clinic/Center
  • Mitchell, SD
National Provider Identifier
1073649901
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
DPT INC
Practice address
1319 W Havens St
Mitchell, SD 57301-4116
Phone
(605) 996-4778
NPI assigned
Feb 26, 2007
Last updated
Sep 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Mr. Joshua M Moody, MSPTNPI 1356319701
Title
Therapist
Phone
(605) 996-4778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X SD Primary

Addresses

Primary practice location

1319 W Havens St
Mitchell, SD 57301-4116

Mailing address

1319 W Havens St
Mitchell, SD 57301-4116
Phone (605) 996-4778

Other identifiers 4

IdentifierTypeStateIssuer
9213206OtherSDDAKOTA CARE
4998325OtherSDBLUE CROSS BLUE SHIELD
5834960MedicaidSD
P00278968OtherSDMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000384 SD Part B Supplier - Clinic/Group Practice 3375453376 Receives reassigned benefits from 11 practitioners
Practice locations: Mitchell, SD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • DPT Inc

    dba Dakota Physical Therapy Home Health Care

    • Home Health Agency
    • Mitchell, SD
    • NPI 1720047616

    3375453376

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Dakota Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

  • DPT Inc

    dba Dakota Physical Therapy Home Health Care

    • Home Health Agency
    • Mitchell, SD
    • NPI 1720047616
    NPD tax ID

Locations

1319 W Havens Ave
Mitchell, SD 57301
Phone (605) 996-4778

910 S Edgerton St
Mitchell, SD 57301
Phone (605) 996-4778

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1073649901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 W HAVENS ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014116",
            "telephone_number": "605-996-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 W HAVENS ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014116",
            "telephone_number": "605-996-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "605-996-4778",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "9213206",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4998325",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5834960",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00278968",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.