Wilfred Joseph Dietrich, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

138 Service Rd
Ste A114
East Lansing, MI 48824-1313

Phone

(517) 355-7648

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Practice roles

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.

• Michigan State University

  • Local Education Agency (LEA)
  • East Lansing, MI
  • NPI 1184182982
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1235272261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 SERVICE RD",
            "address_2": "SUITE A114",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241376",
            "telephone_number": "517-355-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 SERVICE RD",
            "address_2": "STE A114",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241313",
            "telephone_number": "517-355-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "WILFRED",
        "middle_name": "JOSEPH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Trebilcock
• Elliana Diaz
• Arianna Charae Dickason
• Scott Carver Dickinson, DDS
• Marcia Anne Diedrich, SLP
• Douglas Paul Dietzel, D.O.
• Alexandria Faith Diller
• Matthew James Dimagno, MD
• Robert J Dimitriou, M.D.
• Dinah Weststrate LMSW, LLC

• Physical Therapy Assistant in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.