Individual provider Active NPI

Dean Alan Myers, P.T.

  • Physical Therapist
  • Anacortes, WA
National Provider Identifier
1104961408
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 00007036 Issued in WA
Practice address
1105 27TH St
Anacortes, WA 98221-2797
Phone
(360) 293-3174
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-2041 ID
Physical Therapist 225100000X PT 00007036 WA Primary

Addresses

Primary practice location

1105 27TH St
Anacortes, WA 98221-2797

Mailing address

1105 27TH St
Anacortes, WA 98221-2797
Phone (360) 293-3174

Other identifiers 1

IdentifierTypeStateIssuer
1040879MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
PT-2041IDMDPhysical Therapist
PT 00007036WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1104961408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 27TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212797",
            "telephone_number": "360-293-3174",
            "fax_number": "360-293-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 27TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212797",
            "telephone_number": "360-293-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "DEAN",
        "middle_name": "ALAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2041",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 00007036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1040879",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.