Dalton Andrew Bartley
Individual provider Active NPI Occupational Therapist · Carmi, IL
NPI 1689148173 · NPPES record last updated Jan 17, 2019
Key facts
- NPI
- 1689148173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056.012845 (IL)
- Practice address
- 108 April Ave
Carmi, IL 62821 - Phone
- (618) 382-2771
- NPI assigned
- Jan 17, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Joyner Therapy Services
Practice addresses (Care Compare)
108 April Ave
Carmi, IL 62821-1577
Phone (618) 382-2771
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190918003459 | IL | Practitioner - Occupational Therapist in Private Practice | 2769712652 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.012845 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joyner Therapy Services | Current |
Accepting new patients |
Locations
108 April Ave
Carmi, IL 62821
Phone (618) 382-2771
2907 Williamson County Pkwy
Marion, IL 62959
Phone (618) 998-9894
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.012845 | IL | Yes |
Addresses
Primary practice location
108 April Ave
Carmi, IL 62821
Mailing address
912 Co Rd 1350 N
Carmi, IL 62821
Phone (618) 384-1341
NPI Registry JSON
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547683200000",
"number": "1689148173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 CO RD 1350 N",
"city": "CARMI",
"state": "IL",
"postal_code": "62821",
"telephone_number": "618-384-1341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 APRIL AVE",
"city": "CARMI",
"state": "IL",
"postal_code": "62821",
"telephone_number": "618-382-2771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTLEY",
"first_name": "DALTON",
"middle_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-17",
"last_updated": "2019-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.012845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmi, IL
- Aegis Group Practice LLC
- Amy Weasel
- Lesley Angenend
- Thomas J Arnold
- Debbie Baker
- Molly Elizabeth Belford
- Monica Renae Blockley
- Hannah K Bosaw
- Beth E Bowen
- Cassidie R Brown
All providers in Carmi, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.