Alfred James Dyer, PT
Individual provider Active NPI Physical Therapist · Bluefield, VA
NPI 1184705204 · NPPES record last updated Nov 20, 2015
Key facts
- NPI
- 1184705204
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305006291 (VA)
- Practice address
- 134 S College Ave
Bluefield, VA 24605-1705 - Phone
- (276) 325-5020
- Fax
- (276) 325-5029
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
134 S College Ave
Bluefield, VA 24605-1705
Phone (276) 325-5020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122001533 | VA | Practitioner - Physical Therapist in Private Practice | 2668565946 | Practice locations: Bluefield, VA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305006291 | VA | MD | Physical Therapist |
| 001290 | WV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Virginia Vascular Institute PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 001290 | WV | |
| Physical Therapist | 225100000X | 2305006291 | VA | Yes |
Addresses
Primary practice location
134 S College Ave
Bluefield, VA 24605-1705
Mailing address
1400 Augusta St
Bluefield, WV 24701-3810
Phone (304) 960-1637
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7301086-000 | Medicaid | WV | |
| 4059211 | Other | MEDICARE PTAN |
Other providers in Bluefield, VA
- Dermatology Clinics of Southwest Virginias PLLC
- Hilary Beth Deskins
- Holly Disibbio
- Bobby Quentin Dunford
- Donna Elaine Dunford
- East River Psychiatry
- Constance L. Erickson
- Kimberly Erskin
- Emily Evans
- Ralph Evans
All providers in Bluefield, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.