Diane Elizabeth Anderson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1329-019 Issued in WI

Practice address

316 N Milwaukee St Ste 208
Milwaukee, WI 53202-5803

Phone

(414) 615-0665

Fax

(414) 615-0667

NPI assigned

Jul 23, 2007

Last updated

May 6, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1093915472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17085 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531515523",
            "telephone_number": "262-617-7748",
            "fax_number": "262-786-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N MILWAUKEE ST STE 208",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025803",
            "telephone_number": "414-615-0665",
            "fax_number": "414-615-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1329-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra A Anderson, RN
• Debra L Anderson
• Demetrius Levance Anderson Sr., LPC CSW
• Denise Anderson
• Diana Lee Anderson
• Elizabeth Anderson, DO
• Eric R Anderson, MD
• Garrett B Anderson, PA
• Gwen Marie Anderson
• Helen Anderson

• Physical Therapy Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.