Active NPI
Diane H Todd, PT
- Physical Therapist
- Melbourne, FL
National Provider Identifier
1417028580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT21028
- 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
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 |
|---|---|---|---|---|
| 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.