Dyke Charles Dickie, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

841 E Lincoln Ave
Sunnyside, WA 98944-2347

Phone

(509) 839-0414

Fax

(509) 839-8847

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093896375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442347",
            "telephone_number": "509-839-0414",
            "fax_number": "509-839-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442347",
            "telephone_number": "509-839-0414",
            "fax_number": "509-839-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKIE",
        "first_name": "DYKE",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7010374",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "96617",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.