Dalles S Merriman

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2001028596 Issued in MO

Practice address

1010 Ste Genevieve Dr
Ste Genevieve, MO 63670-1447

Phone

(573) 883-5725

NPI assigned

May 25, 2022

Sex

Male

Sole proprietor

No

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

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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1093453375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12714 TALL PINE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636708622",
            "telephone_number": "573-535-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 STE GENEVIEVE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701447",
            "telephone_number": "573-883-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIMAN",
        "first_name": "DALLES",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2001028596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica K Mazurkiewicz, LPC
• Mary A McCullough, ANP
• Mark A McKenzie, R.PH
• Vicki L. McKiel, LPC
• Caitlin McMullen, OTR
• Anthony James Meyer
• Callista Miller, SLP
• Seth Daniel Miller
• Rachel M Millinger
• Missouri CVS Pharmacy LLC

• Physical Therapy Assistant in Ste Genevieve, MO
• Providers in Ste Genevieve, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.