Joshua Alan Dietze, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6714 Issued in MN

Practice address

31095 Berquist Dr
Pequot Lakes, MN 56472-5647

Phone

(218) 568-7767

NPI assigned

Jan 17, 2014

Last updated

Feb 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pequot Lakes Chiropractic PA

  • Chiropractor
  • Pequot Lakes, MN
  • NPI 1417540774
  NPD Authorized official
• Atlas Aligned LLC

  dba Comprehensive Chiropractic Center

  • Chiropractor
  • Oconto Falls, WI
  • NPI 1265030589
  NPD

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1467874941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "564720281",
            "telephone_number": "218-568-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31095 BERQUIST DR",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "564725647",
            "telephone_number": "218-568-7767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 N Chestnut Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541109",
            "country_code": "US",
            "telephone_number": "920-848-2392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETZE",
        "first_name": "JOSHUA",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-17",
        "last_updated": "2021-02-05",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4951-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Dennis Buell, DC
• Caring Hearts Senior Community, LLC
• Changing Strides Therapy LLC
• Richard William Conway
• Crow Wing & Cass Cos Ind School Dist No 186
• Darren Lee Golden, RPH
• Mindy Sue Howard
• Nadine Indihar, DC
• Inmotion Physical Therapy LLC
• John Kloster (Pequot Eye Center)

• Chiropractor in Pequot Lakes, MN
• Providers in Pequot Lakes, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.