Individual provider Active NPI

Diane H Todd, PT

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1417028580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21028 Issued in FL
Practice address
7025 N Wickham Rd
Suite 111
Melbourne, FL 32940-7534
Phone
(321) 752-9778
Fax
(321) 752-9178
NPI assigned
Nov 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT21028 FL Primary

Addresses

Primary practice location

7025 N Wickham Rd
Suite 111
Melbourne, FL 32940-7534

Mailing address

8584 Eden Isles LN
Merritt Island, FL 32952-6800
Phone (321) 795-6007

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

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417028580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8584 EDEN ISLES LN",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329526800",
            "telephone_number": "321-795-6007",
            "fax_number": "321-779-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 N WICKHAM RD",
            "address_2": "SUITE 111",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407534",
            "telephone_number": "321-752-9778",
            "fax_number": "321-752-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "DIANE",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

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

Verify at the official NPI Registry.