Individual provider Active NPI

Dylan Sheedy, DPT

  • Physical Therapist
  • Candler, NC
National Provider Identifier
1548868912
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P19776 Issued in NC
Practice address
1572 Sand Hill Rd Ste 101
Candler, NC 28715-0470
Phone
(828) 552-5342
Fax
(828) 641-9303
NPI assigned
Oct 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 P19776 NC Primary

Addresses

Primary practice location

1572 Sand Hill Rd Ste 101
Candler, NC 28715-0470

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210709001596 NC Practitioner - Physical Therapist in Private Practice 9638571888 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P19776NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physical Therapy, LLC Physical Therapist CurrentSince Jun 7, 2021 Accepting new patients
Henderson County Hospital Corporation PastSince Oct 1, 2020 Accepting new patients

Locations

19 Westridge Market Pl
Candler, NC 28715
Phone (828) 274-2188

59 Weaver Village Way
Weaverville, NC 28787
Phone (828) 484-9415

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": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1548868912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1572 SAND HILL RD STE 101",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287150470",
            "telephone_number": "828-552-5342",
            "fax_number": "828-641-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEDY",
        "first_name": "DYLAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Candler, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.