Dillon Fedak, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070022752 Issued in IL

Practice address

8840 Cypress Waters Blvd
Ste300
Coppell, TX 75019-4594

Phone

(866) 217-8011

NPI assigned

Sep 8, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mote Wellness & Rehab Inc

  • Chiropractor
  • Boynton Beach, FL
  • NPI 1326011917
  NPD (past)

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1114474038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 CYPRESS WATERS BLVD",
            "address_2": "STE300",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194594",
            "telephone_number": "866-217-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 CYPRESS WATERS BLVD",
            "address_2": "STE300",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194594",
            "telephone_number": "866-217-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDAK",
        "first_name": "DILLON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040504",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Faller, M.A., L.P.C.
• Katelin Emily Faria, MS, OTR/L
• Oladayo Simeon Farodoye, PMHNP-BC
• Margaret Elliott Faul
• Alexandra Feagin, CCC-SLP
• Micheala Marie Ferguson, NP-C
• Karen Denise Ferrell
• Grace Marie Fesler, M.S., CCC-SLP
• Cristina Fetter, M.S. CCC/SLP
• Fifty 50 Medical LLC

• Physical Therapist in Coppell, TX
• Providers in Coppell, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.