Active NPI
Travis Robert Dickey, PHYSICAL THERAPIST
- Physical Therapist
- Warren, OH
National Provider Identifier
1235586264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014418
- Practice address
- 4329 Mahoning Ave. NW
Warren, OH 44483 - Phone
- (330) 847-7819
- Fax
- (330) 847-8192
- NPI assigned
- May 19, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT014418 | OH | Primary |
Addresses
Primary practice location
4329 Mahoning Ave. NW
Warren, OH 44483
Mailing address
510 W. Main St.
Canfield, OH 44406
Phone (330) 702-0110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014418 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1235586264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 W. MAIN ST.",
"city": "CANFIELD",
"state": "OH",
"postal_code": "44406",
"telephone_number": "330-702-0110",
"fax_number": "330-702-0510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4329 MAHONING AVE. NW",
"city": "WARREN",
"state": "OH",
"postal_code": "44483",
"telephone_number": "330-847-7819",
"fax_number": "330-847-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKEY",
"first_name": "TRAVIS",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-19",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT014418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.