Individual provider Active NPI

Dartell Dante Treadwell, DPT

  • Physical Therapist
  • Jonesboro, AR
National Provider Identifier
1245560606
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3059 Issued in AR
Practice address
2104 Trinity Oaks Dr
Jonesboro, AR 72401-3662
Phone
(870) 882-6921
NPI assigned
Jan 7, 2010
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3059 AR Primary

Addresses

Primary practice location

2104 Trinity Oaks Dr
Jonesboro, AR 72401-3662

Mailing address

1728 Westwood CV
Jonesboro, AR 72401-4793
Phone (870) 219-9700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3059ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Physical Therapy Current Accepting new patients
Therapeutic Exercise Rehabilitation & Wellness, Inc Physical Therapist CurrentSince Mar 3, 2011 Accepting new patients
Arkansas Kids in Motion Past Accepting new patients

Locations

1421 W Nettleton Ave
Jonesboro, AR 72401
Phone (870) 926-0271

361 Southwest Dr
Jonesboro, AR 72401
Phone (870) 219-1407

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1245560606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 WESTWOOD CV",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014793",
            "telephone_number": "870-219-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 TRINITY OAKS DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013662",
            "telephone_number": "870-882-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "DARTELL",
        "middle_name": "DANTE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-07",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "3059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.