Active NPI
Daniel Dennis Tardy, PT
- Physical Therapist
- Brewer, ME
National Provider Identifier
1316168370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1060
- Practice address
- 40 Chapman St
Brewer, ME 04412-1810 - Phone
- (207) 478-6506
- Fax
- (978) 225-2251
- NPI assigned
- May 1, 2007
- 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 | PT1060 | ME | Primary |
Addresses
Primary practice location
40 Chapman St
Brewer, ME 04412-1810
Mailing address
40 Chapman Street
Brewer, ME 04412
Phone (207) 478-6506
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 510550598 | Other | ME | GREAT WEST |
| 3662706 | Other | ME | CIGNA |
| AA34198 | Other | ME | HARVARD PILGRAM |
| P00286049 | Other | ME | RR MEDICARE |
| 048932 | Other | ME | ANTHEM |
| 11317104 | Other | ME | CAQH |
| 1393159 | Other | ME | AETNA |
| 260240000 | Medicaid | ME |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505260800000",
"number": "1316168370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 CHAPMAN STREET",
"city": "BREWER",
"state": "ME",
"postal_code": "04412",
"telephone_number": "207-478-6506",
"fax_number": "207-989-9037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 CHAPMAN ST",
"city": "BREWER",
"state": "ME",
"postal_code": "044121810",
"telephone_number": "207-478-6506",
"fax_number": "978-225-2251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARDY",
"first_name": "DANIEL",
"middle_name": "DENNIS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2017-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT1060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "510550598",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3662706",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRAM",
"identifier": "AA34198",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00286049",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "048932",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11317104",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1393159",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260240000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brewer, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.