Active NPI
Damon Doler, PT
- Physical Therapist
- Bruce, MS
National Provider Identifier
1710286356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT2016
- Practice address
- 176 Hwy 9
Bruce, MS 38915 - Phone
- (662) 414-5280
- NPI assigned
- Mar 22, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2016 | MS | Primary |
Addresses
Primary practice location
176 Hwy 9
Bruce, MS 38915
Mailing address
PO Box 1205
Calhoun City, MS 38916-1205
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2016 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300752000000",
"number": "1710286356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1205",
"city": "CALHOUN CITY",
"state": "MS",
"postal_code": "389161205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 HWY 9",
"city": "BRUCE",
"state": "MS",
"postal_code": "38915",
"telephone_number": "662-414-5280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLER",
"first_name": "DAMON",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-22",
"last_updated": "2011-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT2016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bruce, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.