Emmanuel Jr. Dy-Liacco Flores, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

02594 Issued in IA

Practice address

2700 1St Ave S
Suite 200
Fort Dodge, IA 50501-4306

Phone

(515) 955-6922

Fax

(515) 955-2463

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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.

• Millennium Rehab & Consulting, Inc.

  • Physical Therapist
  • Des Moines, IA
  • NPI 1255385852
  NPD (past)
• Millennium Rehab & Consulting, Inc.

  • Physical Therapist
  • Fort Dodge, IA
  • NPI 1376597708
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578683033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 12TH AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505012527",
            "telephone_number": "515-576-6524",
            "fax_number": "515-955-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 1ST AVE S",
            "address_2": "SUITE 200",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014306",
            "telephone_number": "515-955-6922",
            "fax_number": "515-955-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "EMMANUEL JR.",
        "middle_name": "DY-LIACCO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Zakhariy Fishman, D.C.
• Tami Jo Fitzgerald Davis, R.N.
• Five Star Feet, PLLC
• Lisa Marie Flaherty
• Morgan Flaherty, ARNP
• Elizabeth Folsom
• Jeffrey Scott Foreman, O.D.
• Fort Dodge Chiropractic Center PLC
• Fort Dodge Health, Inc.
• Fort Dodge Oral and Maxillofacial Surgery LLP

• All providers in Fort Dodge, IA
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.