Active NPI
Dale Arthur Tommervik, PT
- Military Health Care Provider
National Provider Identifier
1821188095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- PT00000836
- Practice address
- Usahc-SFT
CMR 457
Apo, AE 09033 - Phone
- 499721966561
- NPI assigned
- Oct 16, 2006
- Last updated
- Apr 20, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | PT00000836 | WA | Primary |
Addresses
Primary practice location
Usahc-SFT
CMR 457
Apo, AE 09033
Mailing address
CMR 475
Box 375
Apo, AE 09033
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 |
|---|---|---|---|
| PT00000836 | WA | MD | Military Health Care Provider |
| 025208 | WA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Washington Physical Therapy | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Yakima, WA
- NPI 1437196771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208649600000",
"number": "1821188095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "CMR 475",
"address_2": "BOX 375",
"city": "APO",
"state": "AE",
"postal_code": "09033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "MIL",
"address_1": "USAHC-SFT",
"address_2": "CMR 457",
"city": "APO",
"state": "AE",
"postal_code": "09033",
"telephone_number": "499721966561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMMERVIK",
"first_name": "DALE",
"middle_name": "ARTHUR",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2008-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "WA",
"license": "PT00000836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.