Individual provider Active NPI

Diana H. Fletcher, PT

  • Physical Therapist
  • Goodyear, AZ
National Provider Identifier
1104090729
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8304 Issued in AZ
Practice address
1626 N Litchfield Rd Ste 310
Goodyear, AZ 85395-1397
Phone
(623) 935-0734
Fax
(623) 935-0934
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8304 AZ Primary

Addresses

Primary practice location

1626 N Litchfield Rd Ste 310
Goodyear, AZ 85395-1397

Mailing address

1626 N Litchfield Rd Ste 310
Goodyear, AZ 85395-1397
Phone (623) 935-0734

Other identifiers 1

IdentifierTypeStateIssuer
1104090729OtherAZNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090608000082 AZ Practitioner - Physical Therapist in Private Practice 2668541962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spooner Physical Therapy and Hand Rehab, PCGroup PAC ID 3476440447, 202 clinicians

Practice addresses (Care Compare)

1626 N Litchfield Rd
Suite 310
Goodyear, AZ 85395-1397
Phone (623) 935-0734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Sep 26, 2023 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Sep 26, 2023 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Past Accepting new patients

Locations

1626 N Litchfield Rd
Ste 310
Goodyear, AZ 85395
Phone (623) 680-0036

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

14287 N 87th St
Ste 220
Scottsdale, AZ 85260

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1104090729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 N LITCHFIELD RD STE 310",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951397",
            "telephone_number": "623-935-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 N LITCHFIELD RD STE 310",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951397",
            "telephone_number": "623-935-0734",
            "fax_number": "623-935-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "DIANA",
        "middle_name": "H.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104090729",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.