Individual provider Active NPI

Diana Elizabeth Naumann, PT, BSPT

  • Physical Therapist
  • Raytown, MO
National Provider Identifier
1174560007
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
103226 Issued in MO
Practice address
10801 E State Route 350 Ste B
Raytown, MO 64138-2384
Phone
(816) 737-5502
Fax
(816) 737-5504
NPI assigned
May 31, 2006
Last updated
May 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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 103226 MO Primary

Addresses

Primary practice location

10801 E State Route 350 Ste B
Raytown, MO 64138-2384

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other identifiers 2

IdentifierTypeStateIssuer
MA4370040OtherMOMEDICARE PTAN
21304107OtherBCBS KC

Other names 1

  • Diana E Davis Former name

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

LicenseStateTypeSpecialty
103226MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Extremity Rehabilitation Center of Raytown Inc Physical Therapist Past Accepting new patients
Serc Hand of Cass County LLC Past Accepting new patients
Mid America Balance Institute of Cass County Missouri Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1174560007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 E STATE ROUTE 350 STE B",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641382384",
            "telephone_number": "816-737-5502",
            "fax_number": "816-737-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUMANN",
        "first_name": "DIANA",
        "middle_name": "ELIZABETH",
        "credential": "PT, BSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "103226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA4370040",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "21304107",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "DAVIS",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raytown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.