Trudi M Dibble, PT ASSISTANT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI001937 Issued in PA

Practice address

11893 Route 6
Wellsboro, PA 16901-6999

Phone

(570) 723-0675

NPI assigned

Jun 30, 2016

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Upmc Wellsboro

  • Critical Access Hospital
  • Wellsboro, PA
  • NPI 1427501766
  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1528419652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11893 ROUTE 6",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169016999",
            "telephone_number": "570-723-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11893 ROUTE 6",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169016999",
            "telephone_number": "570-723-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "TRUDI",
        "middle_name": "M",
        "credential": "PT ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI001937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kull Czako, CFNP
• Leonard E. Dale II, MD
• Dca of Wellsboro, LLC
• Crystal Deitrick, M.ED., LPC
• Mitchell Dent, DNP, CRNA
• Autumn Elizabeth Dietrich
• Doan Med LLC
• Nicole Elizabeth Doan
• Perry Wynn Doan Jr., DO
• Christopher Anthony Domarew, M.D.,PHARMD, RPH

• Physical Therapy Assistant in Wellsboro, PA
• Providers in Wellsboro, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.