Organization Active NPI

Julie Dieterle

  • Physical Therapist
  • Madison, WI
National Provider Identifier
1013938182
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
953-024 Issued in WI
Legal business name
JULIE DIETERLE
Practice address
330 S Whitney Way
Suite 202
Madison, WI 53705-4638
Phone
(608) 231-3678
Fax
(608) 231-1856
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie Mary Dieterle, P.T.NPI 1326075771
Title
Owner
Phone
(608) 231-3678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 953-024 WI Primary

Addresses

Primary practice location

330 S Whitney Way
Suite 202
Madison, WI 53705-4638

Mailing address

330 S Whitney Way
Suite 202
Madison, WI 53705-4638
Phone (608) 231-3678

Other identifiers 1

IdentifierTypeStateIssuer
40132500MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013938182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S WHITNEY WAY",
            "address_2": "SUITE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054638",
            "telephone_number": "608-231-3678",
            "fax_number": "608-231-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S WHITNEY WAY",
            "address_2": "SUITE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054638",
            "telephone_number": "608-231-3678",
            "fax_number": "608-231-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE DIETERLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIETERLE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-231-3678",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "953-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40132500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.