Active NPI
Julie Dieterle
- Physical Therapist
- Madison, WI
National Provider Identifier
1013938182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 953-024
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Julie Mary Dieterle, P.T.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40132500 | Medicaid | WI |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Madison, WI
- NPI 1326075771
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.