Tara Marie Dewolfe, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

03888 Issued in IA

Practice address

2535 Maplecrest Rd Ste 23
Bettendorf, IA 52722-2716

Phone

(563) 421-3497

Fax

(563) 421-3699

NPI assigned

Sep 17, 2009

Last updated

Sep 17, 2009By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Genesis Health System

  dba Genesis Medical Center Dewitt

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD (past)
• Genesis Health System

  dba Genesis Pediatric Physical Therapy Clinic

  • Physical Therapy Clinic/Center
  • Coralville, IA
  • NPI 1902107261
  NPD (past)

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1639402977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 MAPLECREST RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227709",
            "telephone_number": "563-421-3497",
            "fax_number": "563-421-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 MAPLECREST RD STE 23",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222716",
            "telephone_number": "563-421-3497",
            "fax_number": "563-421-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWOLFE",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IA",
            "license": "03888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan R Deneve, DPT
• Dentistry Unlimited 1 PLC
• Department of Veterans Affairs
• Jason J Deutmeyer, MD
• Matthew B Dewild, RN, LMT
• Ashley Renee Dillard, LCPC, LMHC
• Benjamin Dille, M.D.
• Kyle Dirck, DC
• Alyssa M Donahue, ARNP
• Andrew Donnelly, DC

• Pediatric Physical Therapist in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Pediatric Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.