Diane M Visich, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003226 Issued in MI

Practice address

211 S Crapo St
Suite a
Mount Pleasant, MI 48858-2961

Phone

(989) 775-3823

Fax

(989) 773-5061

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1023048055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 994",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488010994",
            "telephone_number": "989-775-7641",
            "fax_number": "989-775-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S CRAPO ST",
            "address_2": "SUITE A",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582961",
            "telephone_number": "989-775-3823",
            "fax_number": "989-773-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISICH",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0853701290",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Vick, ATC
• Rachel Lynn Vick, PTA
• Vie Therapy LLC
• Autumn View
• Jennifer Junne Vincent, RN
• Roderick S Vogel, DO
• Roman Vorhees
• Sara Vos, M.A., CCC-SLP
• Kaitlyn Vreeland
• Shreya Wachob, DO

• Physician Assistant in Mount Pleasant, MI
• Providers in Mount Pleasant, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.