Active NPI
Melinda Sue Dietz, LAT, AT, ATC
- Athletic Trainer
- Taylor, MI
National Provider Identifier
1346887700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 14717 Hampden St
Taylor, MI 48180-6101 - Phone
- (734) 664-0077
- NPI assigned
- Dec 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | MI | Primary |
Addresses
Primary practice location
14717 Hampden St
Taylor, MI 48180-6101
Mailing address
14717 Hampden St
Taylor, MI 48180-6101
Phone (734) 664-0077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 893614894 | Other | MI | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dietz1ms@cmich.edu |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649030400000",
"number": "1346887700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14717 HAMPDEN ST",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481806101",
"telephone_number": "734-664-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14717 HAMPDEN ST",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481806101",
"telephone_number": "734-664-0077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZ",
"first_name": "MELINDA",
"middle_name": "SUE",
"credential": "LAT, AT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-04",
"last_updated": "2022-04-04",
"certification_date": "2022-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "893614894",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dietz1ms@cmich.edu",
"affiliation": "N",
"endpointDescription": "email address",
"address_1": "14717 Hampden St",
"city": "Taylor",
"state": "MI",
"country_code": "US",
"postal_code": "481806101",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Taylor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.