Individual provider Active NPI

Diane Letellier, PTA

  • Physical Therapy Assistant
  • Topsfield, MA
National Provider Identifier
1497099907
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8030 Issued in MA
Practice address
91 Ipswich Rd
Topsfield, MA 01983-1411
Phone
(978) 561-1595
NPI assigned
Nov 21, 2012
Last updated
Nov 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8030 MA Primary

Addresses

Primary practice location

91 Ipswich Rd
Topsfield, MA 01983-1411

Mailing address

91 Ipswich Rd
Topsfield, MA 01983-1411
Phone (978) 561-1595

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8030MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1497099907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 IPSWICH RD",
            "city": "TOPSFIELD",
            "state": "MA",
            "postal_code": "019831411",
            "telephone_number": "978-561-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 IPSWICH RD",
            "city": "TOPSFIELD",
            "state": "MA",
            "postal_code": "019831411",
            "telephone_number": "978-561-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETELLIER",
        "first_name": "DIANE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "8030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.