Individual provider Active NPI

Dustin Zink, DPT

  • Physical Therapist
  • Salem, OR
National Provider Identifier
1508431925
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64103 Issued in OR
Practice address
1025 2ND St NW
Salem, OR 97304-4001
Phone
(503) 339-7556
NPI assigned
May 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 64103 OR Primary

Addresses

Primary practice location

1025 2ND St NW
Salem, OR 97304-4001

Mailing address

1025 2ND St NW
Salem, OR 97304-4001
Phone (503) 371-0779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621000848 OR Practitioner - Physical Therapist in Private Practice 7315347838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64103ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Edge Physical Therapy & Sports Medicine P.C. CurrentSince Mar 24, 2024 Accepting new patients
Pacific Neuro Therapy Physical Therapist Past Accepting new patients

Locations

2020 8th Ave
Ste D
West Linn, OR 97068
Phone (503) 387-5449

Organizations & group practices 2

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1508431925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 2ND ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044001",
            "telephone_number": "503-371-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 2ND ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044001",
            "telephone_number": "503-339-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINK",
        "first_name": "DUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.