Dustin Alan Davidson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-1370 Issued in WY

Practice address

4120 S Poplar St
Casper, WY 82601-6104

Phone

(307) 333-2873

NPI assigned

Jun 30, 2011

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 WY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Physical Therapy LLCGroup PAC ID 4880905694, 6 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.

• Optimal Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Casper, WY
  • NPI 1962894451

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1356638167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 S POPLAR ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826016104",
            "telephone_number": "307-333-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 S POPLAR ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826016104",
            "telephone_number": "307-333-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DUSTIN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-1370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Marie Datko, MD
• Mark S Daugherity, MPT
• Braelyn Davenport
• David a Baxter IV, MD, PC
• Alexandru Petre David, M.D.
• Dawn R Davies, PMHNP
• Davis Home Health LLC
• Davis Periodontics
• Cynthia Elaine Davis, AA, BA
• Elizabeth Davis

• Physical Therapist in Casper, WY
• Providers in Casper, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.