Active NPI
Michael Dedonder, PT, DPT
- Physical Therapist
- Manhattan, KS
National Provider Identifier
1992181614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-05206
- Practice address
- 1133 College Ave
Ste G200
Manhattan, KS 66502-2770 - Phone
- (785) 539-9669
- NPI assigned
- Aug 4, 2015
- Last updated
- Aug 4, 2015
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-05206 | KS | Primary |
Addresses
Primary practice location
1133 College Ave
Ste G200
Manhattan, KS 66502-2770
Mailing address
1133 College Ave
Ste G200
Manhattan, KS 66502-2770
Phone (785) 539-9669
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 |
|---|---|---|---|
| 11-05206 | KS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438646400000",
"number": "1992181614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1133 COLLEGE AVE",
"address_2": "STE G200",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665022770",
"telephone_number": "785-539-9669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 COLLEGE AVE",
"address_2": "STE G200",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665022770",
"telephone_number": "785-539-9669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDONDER",
"first_name": "MICHAEL",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-04",
"last_updated": "2015-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-05206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.