Diane Adele Brooks, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8621 Issued in AZ

Practice address

294 W Carlos Ave
Holbrook, AZ 86025-1846

Phone

(928) 524-2123

Fax

(928) 524-6367

NPI assigned

Aug 3, 2009

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Diane Adele Johnson Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 28, 2009.

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1457582884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 W CARLOS AVE",
            "address_2": "P.O. BOX 668",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251846",
            "telephone_number": "928-524-2123",
            "fax_number": "928-524-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 W CARLOS AVE",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251846",
            "telephone_number": "928-524-2123",
            "fax_number": "928-524-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DIANE",
        "middle_name": "ADELE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006005274",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "6486",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "JOHNSON",
            "middle_name": "ADELE",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Akdhc, LLC
• Christian Matthew Baker, OTR/L
• Rachel Ann Barger
• Andrew Bleak, PHARMD.
• Samuel Kent Bowman, DC
• Francisco Aguirre Casanova Jr., MD
• Changepoint Integrated Health
• Community Bridges, Inc.
• Amity Craig, MS, CCC-SLP
• Bonita Faye Dalton, M.S.,OTR/L

• All providers in Holbrook, AZ
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.