Active NPI
Tyler Dopheide
- Athletic Trainer
- Vermillion, SD
National Provider Identifier
1922413020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0453
- Practice address
- 327 W Dartmouth St
Vermillion, SD 57069-2009 - Phone
- (914) 525-1955
- NPI assigned
- Jun 26, 2014
- Last updated
- Jun 26, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0453 | SD | Primary |
Addresses
Primary practice location
327 W Dartmouth St
Vermillion, SD 57069-2009
Mailing address
327 W Dartmouth St
Vermillion, SD 57069-2009
Phone (914) 525-1955
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0453 | SD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403740800000",
"number": "1922413020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 W DARTMOUTH ST",
"city": "VERMILLION",
"state": "SD",
"postal_code": "570692009",
"telephone_number": "914-525-1955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 W DARTMOUTH ST",
"city": "VERMILLION",
"state": "SD",
"postal_code": "570692009",
"telephone_number": "914-525-1955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOPHEIDE",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-26",
"last_updated": "2014-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SD",
"license": "0453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vermillion, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.