Dawn-Marie Ickes, M.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22362 Issued in CA

Practice address

30085 Comercio
Rancho Santa Margarita, CA 92688-2106

Phone

(818) 822-1600

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• Prosport Physical Therapy Professionals Inc

  • Specialist
  • Rancho Santa Margarita, CA
  • NPI 1487616546
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1194756957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30085 COMERCIO",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882106",
            "telephone_number": "818-822-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30085 COMERCIO",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882106",
            "telephone_number": "818-822-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICKES",
        "first_name": "DAWN-MARIE",
        "credential": "M.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "22362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Huyn, O.D.
• Huy Minh Huynh, DO
• Quynh Thu Thi Huynh, RPH
• I. W. Ho, D.D.S., Inc.
• George Nabil Abdelmalek Ibrahim
• Ilj Enterprises LLC
• Patricia Rose Imasa
• Infant Developmental Services
• Innerhealth Laboratory, Inc
• Innerhealth Labs LLC

• Physical Therapist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.