Active NPI
Jon Paul Dewick, DPT
- Physical Therapist
- Birch Tree, MO
National Provider Identifier
1497905301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2008011475
- Practice address
- RR 2 Box 2430B
Birch Tree, MO 65438-9222 - Phone
- (573) 292-1222
- NPI assigned
- Sep 27, 2008
- 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 | 2008011475 | MO | Primary |
Addresses
Primary practice location
RR 2 Box 2430B
Birch Tree, MO 65438-9222
Mailing address
RR 2 Box 2430B
Birch Tree, MO 65438-9222
Phone (573) 292-1222
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 |
|---|---|---|---|
| 2008011475 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222473600000",
"number": "1497905301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 2 BOX 2430B",
"city": "BIRCH TREE",
"state": "MO",
"postal_code": "654389222",
"telephone_number": "573-292-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 2 BOX 2430B",
"city": "BIRCH TREE",
"state": "MO",
"postal_code": "654389222",
"telephone_number": "573-292-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWICK",
"first_name": "JON",
"middle_name": "PAUL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-27",
"last_updated": "2008-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2008011475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birch Tree, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.