Active NPI
Timothy Vidale, D.P.T.
- Orthopedic Physical Therapist
- Washington, DC
National Provider Identifier
1962772244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 871303
- Practice address
- 1712 I St NW
Suite 410
Washington, DC 20006-3702 - Phone
- (202) 257-1363
- NPI assigned
- Jan 4, 2012
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 871303 | DC | Primary |
Addresses
Primary practice location
1712 I St NW
Suite 410
Washington, DC 20006-3702
Mailing address
103 Webster St NE
Washington, DC 20011-5067
Phone (202) 679-0985
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 |
|---|---|---|---|
| 871303 | DC | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1962772244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 WEBSTER ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115067",
"telephone_number": "202-679-0985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1712 I ST NW",
"address_2": "SUITE 410",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200063702",
"telephone_number": "202-257-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDALE",
"first_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-04",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "DC",
"license": "871303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.