Active NPI
James Michael Druyvestein, PT
- Physical Therapist
- Wasilla, AK
National Provider Identifier
1619143856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1822
- Practice address
- 1700 E Bogard Rd
BLDG B Ste 203
Wasilla, AK 99654-6563 - Phone
- (907) 376-4325
- Fax
- (907) 376-2365
- NPI assigned
- May 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1822 | AK | Primary |
Addresses
Primary practice location
1700 E Bogard Rd
BLDG B Ste 203
Wasilla, AK 99654-6563
Mailing address
11827 Gatesden Dr
Tomball, TX 77377-8581
Phone (605) 670-0155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1822 | AK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210118400000",
"number": "1619143856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11827 GATESDEN DR",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773778581",
"telephone_number": "605-670-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E BOGARD RD",
"address_2": "BLDG B STE 203",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546563",
"telephone_number": "907-376-4325",
"fax_number": "907-376-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRUYVESTEIN",
"first_name": "JAMES",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-07",
"last_updated": "2008-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "1822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.