Individual provider Active NPI

Kim Dimalanta, PT, DPT

  • Physical Therapist
  • Albany, OR
National Provider Identifier
1629635248
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
805 19TH Ave SE
Albany, OR 97322-4225
Phone
(805) 612-7788
NPI assigned
May 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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 Primary

Addresses

Primary practice location

805 19TH Ave SE
Albany, OR 97322-4225

Mailing address

3765 Calle Clara Vis
Newbury Park, CA 91320-1912
Phone (805) 612-7788

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1629635248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3765 CALLE CLARA VIS",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913201912",
            "telephone_number": "805-612-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 19TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973224225",
            "telephone_number": "805-612-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMALANTA",
        "first_name": "KIM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.