Individual provider Active NPI

Maria Walchli Dunlop, PT

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1255655478
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
002510 Issued in KY
Practice address
15 E Market St
Suite 103
Indianapolis, IN 46204-3001
Phone
(317) 423-0222
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23204 CA
Physical Therapist 225100000X 05006110A IN
Geriatric Physical Therapist 2251G0304X 002510 KY
Physical Therapist 225100000X 002510 KY Primary

Addresses

Primary practice location

15 E Market St
Suite 103
Indianapolis, IN 46204-3001

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120206000686 IN Practitioner - Physical Therapist in Private Practice 6800053661 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5 Broadway PLZ
Peru, IN 46970-1052
Phone (765) 327-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05006110AINMDPhysical Therapist
002510KYMDPhysical Therapist
23204CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Oct 20, 2020 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Oct 9, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Oct 20, 2020 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Oct 9, 2021 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince May 13, 2024 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince May 13, 2024 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

98 N 10th St
Greencastle, IN 46135
Phone (765) 301-4642

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

4625 S Emerson Ave
Ste De
Indianapolis, IN 46203
Phone (317) 677-0202

1805 E Hoffer St
Kokomo, IN 46902
Phone (765) 450-7261

5 Broadway Plz
Peru, IN 46970
Phone (765) 327-2111

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1255655478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E MARKET ST",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462043001",
            "telephone_number": "317-423-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNLOP",
        "first_name": "MARIA",
        "middle_name": "WALCHLI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "23204",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006110A",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "KY",
            "license": "002510",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "002510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.