Diveris Orthopedics and Sports Medicine,PC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

01040065A Issued in IN

Legal business name

DIVERIS ORTHOPEDICS AND SPORTS MEDICINE,PC

Doing business as

KDM Physical Therapy

Practice address

2562 Walton Blvd
Warsaw, IN 46582-6522

Phone

(219) 263-8849

Fax

(219) 476-0108

NPI assigned

May 8, 2007

Last updated

Jun 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John M Diveris, MD

Title

President

Phone

(219) 263-8849

Specialties & licenses 1

Addresses

Other names 1

• KDM Physical Therapy Doing business as

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nora Abeledo de Mas, PT

  • Physical Therapist
  • Merrillville, IN
  • NPI 1053400531
  NPD (past)
• Kathleen Belford, PT

  • Physical Therapist
  • Dyer, IN
  • NPI 1194850149
  NPD (past)
• Richard Duttweiler, PHYSICAL THERAPIST

  • Physical Therapist
  • Munster, IN
  • NPI 1124068374
  NPD (past)
• David Allen Franklin, MSPT

  • Physical Therapist
  • Peru, IN
  • NPI 1689692485
  NPD (past)
• Travis Lee Sharp, MPT

  • Physical Therapist
  • Winfield, IN
  • NPI 1538279898
  NPD (past)
• Danielle L Johnson, P.A.

  • Physician Assistant
  • Collierville, TN
  • NPI 1962757740
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1437362076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562 WALTON BLVD",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465826522",
            "telephone_number": "219-263-8849",
            "fax_number": "574-267-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2562 WALTON BLVD",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465826522",
            "telephone_number": "219-263-8849",
            "fax_number": "219-476-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERIS ORTHOPEDICS AND SPORTS MEDICINE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "DIVERIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-263-8849",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "01040065A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KDM Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Richard Digia, LMHC
• Ruth Marie Dilley, MSW
• Todd Allen Dillon, MD
• Alexis Dingus
• Susan Ann Disher, RD CD
• Hannah Dotson
• Trent Doud
• Dr Tabitha G Temple PC
• Dr. Engelberth's Hearing Center, Inc.
• Marsha Lynn Dreyer, COTA

• Sports Medicine (Orthopaedic Surgery) Physician in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.