Individual provider Active NPI

Philip Wayne Dargo

  • Occupational Therapist
  • Muncie, IN
National Provider Identifier
1922651959
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31000151A Issued in IN
Practice address
5401 S Walnut St
Muncie, IN 47302-8778
Phone
(765) 749-8318
NPI assigned
Jul 18, 2019
Last updated
Jul 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31000151A IN Primary

Addresses

Primary practice location

5401 S Walnut St
Muncie, IN 47302-8778

Mailing address

5401 S Walnut St
Muncie, IN 47302-8778
Phone (765) 749-8318

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

LicenseStateTypeSpecialty
31000151AINMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1922651959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 S WALNUT ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473028778",
            "telephone_number": "765-749-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S WALNUT ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473028778",
            "telephone_number": "765-749-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARGO",
        "first_name": "PHILIP",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31000151A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.