Darci Kay Dahl, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A544 Issued in MN

Practice address

4570 County Highway 61
Moose Lake, MN 55767

Phone

(218) 644-0910

Fax

(218) 644-0911

NPI assigned

Mar 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1962038000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 COUNTY HIGHWAY 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-644-0910",
            "fax_number": "218-644-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 COUNTY HIGHWAY 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-644-0910",
            "fax_number": "218-644-0911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Villa Court Dr",
            "address_purpose": "LOCATION",
            "city": "Cromwell",
            "state": "MN",
            "postal_code": "557264503",
            "country_code": "US",
            "telephone_number": "218-485-2020 x2340",
            "fax_number": "218-485-2044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "DARCI",
        "middle_name": "KAY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy H. Brandli, M.D.
• Blake Steven Chapman, DO
• Luann Joyce Charboneau, PT
• Raymond G. Christensen, M.D.
• Heather Cronemiller, MA, LICSW
• Kimberly Mary Davidson, R.N
• Debbie Davis, LPCC
• Paul R. Dewey, M.D.
• Kathryn Dobbs, M.D.
• Downtown Dental Care PA

• All providers in Moose Lake, MN
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.