Chad Dybdahl, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5509 Issued in OR

Practice address

702 SW Ramsey Ave
Ste. 220
Grants Pass, OR 97527-5858

Phone

(541) 479-0765

Fax

(541) 479-3461

NPI assigned

Nov 1, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chad.dybdahl.1@31414.direct.athenahealth.com

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.

• Therapeutic Associates Inc

  • Physical Therapist
  • Ashland, OR
  • NPI 1972589364
  Medicare reassignment Care Compare group NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1962488353
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1124207535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "STE. 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SW RAMSEY AVE",
            "address_2": "STE. 220",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275858",
            "telephone_number": "541-479-0765",
            "fax_number": "541-479-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYBDAHL",
        "first_name": "CHAD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00802462",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278901",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L & I",
            "identifier": "0226042",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy Jada Durkee
• Shaunte Angelique Duron-Okotete
• Kenneth Durrant
• Tina Dutton, LPC
• Kimberly Dyball
• Tanya Dydzyk, BMS
• Ren Dyson, RPH, QMHP-R
• Thomas Eagan, D.O,
• Ear Nose and Throat Associates of Grants Pass PC
• Stacey Earnest

• Physical Therapist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.