NPIMap

Organization Active NPI

DPT Inc

Doing business as Dakota Physical Therapy Home Health Care

  • Home Health Agency
  • Mitchell, SD
National Provider Identifier
1720047616
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
437077 Issued in SD
Legal business name
DPT INC
Doing business as
Dakota Physical Therapy Home Health Care
Practice address
1319 West Havens
Mitchell, SD 57301
Phone
(605) 996-4778
Fax
(605) 996-3660
NPI assigned
Mar 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Josh Moody, PT
Title
Vice President
Phone
(605) 996-4778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 437077 SD Primary

Addresses

Primary practice location

1319 West Havens
Mitchell, SD 57301

Mailing address

1319 West Havens
Mitchell, SD 57301
Phone (605) 996-4778

Other names 1

  • Dakota Physical Therapy Home Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030701000057 SD Part A Provider - Home Health Agency 3375453376 Practice locations: Mitchell, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720047616. Details of each certification follow.

Home health agency certification: CCN 437077

Legal name
DPT INC
Doing business as
DAKOTA PHYSICAL THERAPY HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 12, 2001
Last certification
Jun 3, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 19, 2003 in SD
Enrollment address
910 S Edgerton St
Mitchell, SD 57301-4113

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • DPT Inc
    • Physical Therapy Clinic/Center
    • Mitchell, SD
    • NPI 1073649901

    3375453376

    Same PAC ID

Care Compare: Home health agency

Medicare Care Compare
Listed as
Dakota Physical Therapy Home Health CareCCN 437077 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Sep 12, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D0984733Dakota Physical Therapy Home Health Care910 South Edgerton St, Mitchell, SD 57301Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dakota Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

910 S Edgerton St
Mitchell, SD 57301
Phone (605) 996-4778

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joshua M Moody Individual 5% Or Greater Direct Ownership InterestPhysical Therapist Sep 1, 2005 50%
Corporate DirectorVice President Sep 1, 2005
W-2 Managing EmployeeVice President Sep 1, 2005
Steven L Vangenderen Individual 5% Or Greater Direct Ownership InterestPresident Sep 1, 2005 50%
Corporate OfficerPresident Sep 1, 2005

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720047616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 WEST HAVENS",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "57301",
            "telephone_number": "605-996-4778",
            "fax_number": "605-996-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 WEST HAVENS",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "57301",
            "telephone_number": "605-996-4778",
            "fax_number": "605-996-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "605-996-4778",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SD",
            "license": "437077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dakota Physical Therapy Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.