Active NPI
Meredith Emmanuelle Dalton, PT, DPT
- Physical Therapist
- Jackson, WY
National Provider Identifier
1326721960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-2316
- Practice address
- 625 E Broadway Ave
Jackson, WY 83001-8642 - Phone
- (307) 733-3636
- NPI assigned
- Aug 10, 2023
- Last updated
- Aug 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | PT-2316 | WY | Primary |
Addresses
Primary practice location
625 E Broadway Ave
Jackson, WY 83001-8642
Mailing address
PO Box 3678
Jackson, WY 83001-3678
Phone (615) 587-9208
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 |
|---|---|---|---|
| PT-2316 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1326721960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3678",
"city": "JACKSON",
"state": "WY",
"postal_code": "830013678",
"telephone_number": "615-587-9208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 E BROADWAY AVE",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018642",
"telephone_number": "307-733-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALTON",
"first_name": "MEREDITH",
"middle_name": "EMMANUELLE",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-10",
"last_updated": "2023-08-10",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PT-2316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.