Garrett Dierkes

Individual provider Active NPI Physical Therapist · Caldwell, OH

NPI 1164353041 · NPPES record last updated May 28, 2026

Key facts

NPI
1164353041
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT022413 (OH)
Practice address
305 North St
Caldwell, OH 43724-1215
Phone
(304) 693-2178
NPI assigned
May 28, 2026
Sex
Male
Sole proprietor
No

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Ohio University, College of Osteopathic Medicine, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1500 Grand Central Ave
Suite 101
Vienna, WV 26105-1079

43360 Mount Carrick Rd
Woodsfield, OH 43793-9405

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT022413OHMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT022413 OH Yes

Addresses

Primary practice location

305 North St
Caldwell, OH 43724-1215

Mailing address

1500 Grand Central Ave Ste 101
Vienna, WV 26105-1079

Other providers in Caldwell, OH

All providers in Caldwell, OH · Physical Therapist in Ohio

Sources for this page

Verify at the official NPI Registry.