John B Dudley

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6209 Issued in MN

Practice address

1381 Jefferson Rd
Northfield, MN 55057-3080

Phone

(507) 646-8815

NPI assigned

Dec 20, 2006

Sex

Male

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

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Minnesota Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northfield Physical Therapy LLCGroup PAC ID 4284717356, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northfield Physical Therapy LLC

  • Physical Therapist
  • Northfield, MN
  • NPI 1235310913
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598829152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 COVEY CT",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573331",
            "telephone_number": "507-646-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 JEFFERSON RD",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573080",
            "telephone_number": "507-646-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JOHN",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Dickerson, PT
• Andrew Dimick
• Daniel John Dimick, MA, LP, LMFT
• Meghan G Dimick, CRNA
• Melanie H. Dixon, MD
• Ann L. Dybvik, MS, CCC-SLP
• Dykstra DBP
• E. Cram PA
• Trisha Efta
• Rachel Egeberg

• Physical Therapist in Northfield, MN
• Providers in Northfield, MN by specialty
• Physical Therapist in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.