Provider Demographics
NPI:1366642688
Name:DYE, JAMES E (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:DYE
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3567 VILLAGE CT.
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-1427
Mailing Address - Country:US
Mailing Address - Phone:219-981-8109
Mailing Address - Fax:219-980-8168
Practice Address - Street 1:3567 VILLAGE CT.
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-1427
Practice Address - Country:US
Practice Address - Phone:219-981-8109
Practice Address - Fax:219-980-8168
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002712A2251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200400020AMedicaid
INP01061948OtherMEDICARE RAILROAD
IN000000241485OtherBC/BS
IN000000241486OtherBC/BS
IN000000241485OtherBC/BS