Active NPI
Dalton Lee Hayes, ATC LAT
- Point of Service
- Burlington, IA
National Provider Identifier
1639553761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Point of Service
- License
- 2000021929
- Practice address
- 1616 S 15TH St
Burlington, IA 52601-3744 - Phone
- (319) 457-0502
- NPI assigned
- Jul 18, 2015
- Last updated
- Jul 18, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Point of Service | 305S00000X | 2000021929 | IA | Primary |
Addresses
Primary practice location
1616 S 15TH St
Burlington, IA 52601-3744
Mailing address
1616 South 15TH Street
Burlington, IA 52601
Phone (319) 457-0502
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 |
|---|---|---|---|
| 2000021929 | IA | MD | Point of Service |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437177600000",
"number": "1639553761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 SOUTH 15TH STREET",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "52601",
"telephone_number": "319-457-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 S 15TH ST",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "526013744",
"telephone_number": "319-457-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "DALTON",
"middle_name": "LEE",
"credential": "ATC LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-18",
"last_updated": "2015-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "IA",
"license": "2000021929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.