Individual provider Active NPI

Thomas Justin Yoder, DPT

  • Physical Therapist
  • Dover, DE
National Provider Identifier
1487136404
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0004017 Issued in DE
Practice address
642 S Queen St Ste 101
Dover, DE 19904-3506
Phone
(302) 724-6344
Fax
(302) 449-2047
NPI assigned
Sep 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X DE
Physical Therapist 225100000X J1-0004017 DE Primary

Addresses

Primary practice location

642 S Queen St Ste 101
Dover, DE 19904-3506

Mailing address

1050 Industrial Dr Ste 210
Middletown, DE 19709-2803
Phone (302) 724-6344

Other practice location 1

103 South 7th Street
Denton, MD 21629
Phone (410) 479-0470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190108001649 DE Practitioner - Physical Therapist in Private Practice 2961748280 Reassigns benefits to 2 organizations
I20200511001844 MD Practitioner - Physical Therapist in Private Practice 2961748280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

642 S Queen St
Suite 101
Dover, DE 19904-7794
Phone (302) 724-6344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 10, 2018 Accepting new patients
Advantage Rehab, Inc. Physical Therapist CurrentSince Jan 25, 2020 Accepting new patients
Advantage Rehab, Inc. Physical Therapist CurrentSince Jan 25, 2020 Accepting new patients
Premier Physical Therapy and Sports Performance Limited Partnership CurrentSince Nov 28, 2022 Accepting new patients
Premier Physical Therapy and Sports Performance Limited Partnership Physical Therapist CurrentSince Nov 28, 2022 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 10, 2018 Accepting new patients

Locations

642 S Queen St
Ste 101
Dover, DE 19904
Phone (302) 674-1269

16819 S DuPont Hwy
Ste 500
Harrington, DE 19952
Phone (302) 786-3008

1050 Industrial Dr
Ste 210
Middletown, DE 19709

100 S Main St
Ste 300
Smyrna, DE 19977
Phone (302) 389-7855

790 Remington Blvd
Bolingbrook, IL 60440

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

103 S 7th St
Denton, MD 21629
Phone (410) 479-0470

Organizations & group practices 6

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1487136404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 INDUSTRIAL DR STE 210",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197092803",
            "telephone_number": "302-724-6344",
            "fax_number": "302-449-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 S QUEEN ST STE 101",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043506",
            "telephone_number": "302-724-6344",
            "fax_number": "302-449-2047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 South 7th Street",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "MD",
            "postal_code": "21629",
            "country_code": "US",
            "telephone_number": "410-479-0470",
            "fax_number": "410-479-0526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YODER",
        "first_name": "THOMAS",
        "middle_name": "JUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0004017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.