Individual provider Active NPI

Karis Dewalt, DPT

  • Physical Therapist
  • Toledo, OH
National Provider Identifier
1770280638
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4210 W Sylvania Ave Ste 102
Toledo, OH 43623-4501
Phone
(419) 559-5591
Fax
(866) 268-5006
NPI assigned
Feb 10, 2023
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

4210 W Sylvania Ave Ste 102
Toledo, OH 43623-4501

Mailing address

4210 W Sylvania Ave Ste 102
Toledo, OH 43623-4501
Phone (419) 559-5591

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230224000701 OH Practitioner - Physical Therapist in Private Practice 7517330475 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Pain Services, PLL CurrentSince Feb 13, 2023 Accepting new patients
Toledo Pain Services, PLL CurrentSince Feb 13, 2023 Accepting new patients
PT Link LLC Physical Therapist CurrentSince Feb 11, 2023 Accepting new patients

Locations

1823 W State St
Fremont, OH 43420
Phone (419) 334-7737

1675 Lance Pointe Rd
Maumee, OH 43537
Phone (419) 891-9800

846 S Coy Rd
Ste 100
Oregon, OH 43616

3400 Meijer Dr
Toledo, OH 43617
Phone (419) 531-3500

4210 W Sylvania Ave
Ste 102
Toledo, OH 43623
Phone (419) 350-3347

4349 Talmadge Rd
Toledo, OH 43623
Phone (419) 654-8818

5151 Monroe St
Ste 104
Toledo, OH 43623

108 E Main St
Ste B
Woodville, OH 43469
Phone (419) 849-2900

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1770280638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 W SYLVANIA AVE STE 102",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234501",
            "telephone_number": "419-559-5591",
            "fax_number": "866-268-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 W SYLVANIA AVE STE 102",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234501",
            "telephone_number": "419-559-5591",
            "fax_number": "866-268-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALT",
        "first_name": "KARIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.