Provider Demographics
NPI:1205851409
Name:BARTHELMESS, DARYL JAMES (PT)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:JAMES
Last Name:BARTHELMESS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:29 N ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:DE
Practice Address - Zip Code:19970
Practice Address - Country:US
Practice Address - Phone:302-541-5705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10001462225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD800224-45OtherBC/BS SDSCR
1000025977OtherMEDICAID BAYSIDE PT
MD800224-46OtherBC/BS BAYSIDE PT
DEG02075B02OtherMEDICARE PIN BAYSIDE PT
DE1000038795OtherMEDICAID SDSCR
DE013700S53OtherMEDICARE PIN SDSCR