Active NPI
Daniel Philip Dehart
- Athletic Trainer
- Lakeville, MN
National Provider Identifier
1679929038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- J020101280802
- Practice address
- 20762 Junco CT.
Lakeville, MN 55044-7052 - Phone
- (612) 875-0445
- NPI assigned
- May 4, 2016
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | J020101280802 | MN | Primary |
Addresses
Primary practice location
20762 Junco CT.
Lakeville, MN 55044-7052
Mailing address
20762 Junco CT
Lakeville, MN 55044-7510
Phone (612) 875-0445
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 |
|---|---|---|---|
| J020101280802 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462320000000",
"number": "1679929038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20762 JUNCO CT",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550447510",
"telephone_number": "612-875-0445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20762 JUNCO CT.",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550447052",
"telephone_number": "612-875-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHART",
"first_name": "DANIEL",
"middle_name": "PHILIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-04",
"last_updated": "2016-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "J020101280802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.