Mari Dolores Dieckman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2093 Issued in AZ

Practice address

125 E Elm Ave
Suite 103
Flagstaff, AZ 86001-3258

Phone

(928) 213-9730

Fax

(928) 213-9732

NPI assigned

Jan 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northland-Rural Therapy Associates, LLC

  • Specialist
  • Flagstaff, AZ
  • NPI 1376677914

  Physical Therapist

  NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1225185366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E ELM AVE",
            "address_2": "SUITE 103",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013258",
            "telephone_number": "928-213-9730",
            "fax_number": "928-213-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E ELM AVE",
            "address_2": "SUITE 103",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013258",
            "telephone_number": "928-213-9730",
            "fax_number": "928-213-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKMAN",
        "first_name": "MARI",
        "middle_name": "DOLORES",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2093",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "2093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan P. Dewey, LCSW
• Robin Smerling Dewolfe, LPC
• DHHS IHS Phoenix Area
• Lore M Dickey, PHD
• Kylie Paige Dickman, MD
• Christopher Michael Diefenbach, MD
• Kent A Diehl, MD
• Emily Dietz, RBT
• Jane Ellen Dill, M.D.
• Brittany Dilley, RDN, CNSC

• Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.