Kelsey A Diederich, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9786 Issued in MN

Practice address

St Cloud Hospital
1406 6TH Avenue North
St Cloud, MN 56303-1901

Phone

(320) 251-2700

Fax

(320) 656-7115

NPI assigned

Feb 16, 2017

Last updated

Jul 6, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Medicare reassignment Care Compare group NPD
• Centracare Clinic

  dba CentraCare - River Campus Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1043212665
  Medicare reassignment NPD
• Centracare Clinic

  dba CentraCare Occupations Health

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Centracare Clinic

  dba Central Minnesota Child Advocacy Center (CAC)

  • Exclusive Provider Organization
  • Sartell, MN
  • NPI 1962958611
  NPD
• St. Cloud Hospital

  • Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1619934627
  NPD

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1477092971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST CLOUD HOSPITAL",
            "address_2": "1406 6TH AVENUE NORTH",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST CLOUD HOSPITAL",
            "address_2": "1406 6TH AVENUE NORTH",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDERICH",
        "first_name": "KELSEY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Devos
• Sara Dezell, R.N.
• Gati Niranjan Dhroove, MBBS
• Heather Diaz, PHARMD
• Allison Marie Diederich
• Leah Diederich
• Samantha Dietman
• Tabitha Paige Dietz
• Dima Transportation LLC
• Lindsay J Dingman, PA-C

• Physical Therapist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.