Dalton Michael Von Holdt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61441784 Issued in WA

Practice address

3901 NE 4TH St
Renton, WA 98056-4100

Phone

(425) 616-3841

NPI assigned

Jun 26, 2023

Sex

Male

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

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Outpatient Physical Therapy and Sports Rehabilitation Inc PCGroup PAC ID 3678487063, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Outpatient Physical Therapy & Sports Rehabilitation Inc PC

  • Physical Therapist
  • Maple Valley, WA
  • NPI 1730394420
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1265118988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 NE 4TH ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564100",
            "telephone_number": "425-616-3841",
            "fax_number": "425-390-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NE 4TH ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564100",
            "telephone_number": "425-616-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDT",
        "first_name": "DALTON",
        "middle_name": "MICHAEL VON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61441784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin G Hogland, PA-C
• Jenna Dey Hoiland, O.D.
• Christie Holbrook, RN
• Guy Graham Holcomb, LMP
• Samantha Holcomb, L.M.P.
• Kathlyn Marie Holland
• Tiffany Joy Hollenbeck, OD
• Andrew James Holman, MD
• James Clayton Holman
• Harmony Holme, RN

• Physical Therapist in Renton, WA
• Providers in Renton, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.