Active NPI
Diane McDermott Kleist, PT
- Physical Therapist
- Portsmouth, NH
National Provider Identifier
1114938644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0920
- Practice address
- 152 Court St
Suite 4
Portsmouth, NH 03801-4416 - Phone
- (603) 427-5370
- Fax
- (603) 427-5370
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0920 | NH | Primary |
| Physical Therapist | 225100000X | PT379 | ME |
Addresses
Primary practice location
152 Court St
Suite 4
Portsmouth, NH 03801-4416
Mailing address
152 Court St
Suite 4
Portsmouth, NH 03801-4416
Phone (603) 427-5370
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3533245 | Other | NH | AETNA |
| 0806164Y0NH02 | Other | NH | ANTHEM BC/BS |
| 30392870 | Medicaid | NH | |
| 2198450 | Other | NH | FIRST HEALTH NETWORK |
| 5515310 | Other | NH | CCN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT379 | ME | MD | Physical Therapist |
| 0920 | NH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1114938644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 COURT ST",
"address_2": "SUITE 4",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038014416",
"telephone_number": "603-427-5370",
"fax_number": "603-427-5370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 COURT ST",
"address_2": "SUITE 4",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038014416",
"telephone_number": "603-427-5370",
"fax_number": "603-427-5370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIST",
"first_name": "DIANE",
"middle_name": "MCDERMOTT",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NH",
"license": "0920",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT379",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3533245",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "0806164Y0NH02",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30392870",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH NETWORK",
"identifier": "2198450",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCN",
"identifier": "5515310",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.