Individual provider Active NPI

Alexander Dallas Dettmers, DPT

  • Physical Therapist
  • Springdale, AR
National Provider Identifier
1093634180
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5830 Issued in AR
Practice address
4915 S Thompson St Ste B
Springdale, AR 72764-2551
Phone
(307) 274-5146
NPI assigned
Jul 13, 2026
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 5830 AR Primary

Addresses

Primary practice location

4915 S Thompson St Ste B
Springdale, AR 72764-2551

Mailing address

4915 S Thompson St Ste B
Springdale, AR 72764-2551

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

NPI Registry JSON

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

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093634180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 S THOMPSON ST STE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727642551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 S THOMPSON ST STE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727642551",
            "telephone_number": "307-274-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMERS",
        "first_name": "ALEXANDER",
        "middle_name": "DALLAS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.