Individual provider Active NPI

James R Deston, DPT

  • Physical Therapist
  • Cullman, AL
National Provider Identifier
1790752657
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH7761 Issued in AL
Practice address
1811 Dahlke Dr
Cullman, AL 35058-3625
Phone
(256) 739-1370
Fax
(256) 937-7229
NPI assigned
Mar 1, 2006
Last updated
May 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH7761 AL Primary
Physical Therapist 225100000X PT4177 MS

Addresses

Primary practice location

1811 Dahlke Dr
Cullman, AL 35058-3625

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

11310 Memorial Pkwy SW Ste L
Huntsville, AL 35803-2495
Phone (256) 203-0633

Other practice location 2

324 Sutton Rd SE Ste B
Owens Cross Roads, AL 35763-9412
Phone (256) 288-0045

Other identifiers 1

IdentifierTypeStateIssuer
018853MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016000993 AL Practitioner - Physical Therapist in Private Practice 6002892114 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH7761ALMDPhysical Therapist
PT4177MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy-Alabama, LLC Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Drayer Physical Therapy Alabama LLC CurrentSince May 9, 2022 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 1, 2015 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Dec 1, 2015 Accepting new patients

Locations

1811 Dahlke Dr
Cullman, AL 35058
Phone (256) 739-1370

2215 Decatur Hwy
Ste 125
Gardendale, AL 35071
Phone (205) 285-8790

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

11310 Memorial Pkwy SW
Ste L
Huntsville, AL 35803
Phone (256) 203-0633

4601 Whitesburg Dr SE
Ste 102
Huntsville, AL 35802
Phone (256) 883-1734

7559 Highway 72 W
Ste 110C
Madison, AL 35758
Phone (256) 772-9155

324 Sutton Rd SE
Ste B
Owens Cross Roads, AL 35763
Phone (256) 288-0045

800 Crescent Centre Dr
Ste 300
Franklin, TN 37067

800 Crescent Centre Dr
Ste 600
Franklin, TN 37067
Phone (615) 416-0199

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1790752657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 DAHLKE DR",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350583625",
            "telephone_number": "256-739-1370",
            "fax_number": "256-937-7229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11310 Memorial Pkwy SW Ste L",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358032495",
            "country_code": "US",
            "telephone_number": "256-203-0633",
            "fax_number": "256-203-0688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "324 Sutton Rd SE Ste B",
            "address_purpose": "LOCATION",
            "city": "Owens Cross Roads",
            "state": "AL",
            "postal_code": "357639412",
            "country_code": "US",
            "telephone_number": "256-288-0045",
            "fax_number": "256-288-0046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESTON",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2022-05-04",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH7761",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4177",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018853",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.