Individual provider Active NPI

Dale J Blatter, PT

  • Physical Therapist
  • Richland, WA
National Provider Identifier
1811059199
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006293 Issued in WA
Practice address
343 Wellsian Way
Richland, WA 99352-4116
Phone
(509) 946-9191
Fax
(509) 946-8247
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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 PT00006293 WA Primary

Addresses

Primary practice location

343 Wellsian Way
Richland, WA 99352-4116

Mailing address

7201 W Clearwater Ave
Suite B101
Kennewick, WA 99336-1694
Phone (509) 544-0265

Other identifiers 2

IdentifierTypeStateIssuer
8335077MedicaidWA
0120474OtherWALABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000081 WA Practitioner - Physical Therapist in Private Practice 7911800974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Physical Therapy Inc PSGroup PAC ID 6305747643, 44 clinicians

Practice addresses (Care Compare)

343 Wellsian Way
Richland, WA 99352-4107
Phone (509) 946-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Physical Therapy Inc PS Physical Therapist CurrentSince Jan 1, 2000 Accepting new patients

Locations

7201 W Clearwater Ave
Ste B101
Kennewick, WA 99336
Phone (509) 544-0265

343 Wellsian Way
Richland, WA 99352
Phone (509) 547-3673

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1811059199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 W CLEARWATER AVE",
            "address_2": "SUITE B101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361694",
            "telephone_number": "509-544-0265",
            "fax_number": "509-987-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 WELLSIAN WAY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524116",
            "telephone_number": "509-946-9191",
            "fax_number": "509-946-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTER",
        "first_name": "DALE",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8335077",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0120474",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.