Douglas Fye, P.T., D.P.T., O.C.S.

Key facts

NPI

1144648122

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

015363-1 (NY)

Practice address

17 Lansing St
Auburn, NY 13021-1983

Phone

(315) 255-7440

Fax

(315) 255-7051

NPI assigned

Apr 7, 2014

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 7, 2014.

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1144648122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7388 SILVERWOOD DR",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7440",
            "fax_number": "315-255-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYE",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "P.T., D.P.T., O.C.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015363-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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