Individual provider Active NPI

Diane Lyn Stearns, C,P.T.A.

  • Physical Therapy Assistant
  • Cadillac, MI
National Provider Identifier
1558901454
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502002455 Issued in MI
Practice address
Samaritas Senior Living
460 Pearl Street
Cadillac, MI 49601
Phone
(231) 775-0101
Fax
(231) 775-1390
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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 5502002455 MI Primary

Addresses

Primary practice location

Samaritas Senior Living
460 Pearl Street
Cadillac, MI 49601

Mailing address

Select Rehabilitation, LLC
2600 Compass Road
Glenview, IL 60026
Phone (877) 787-3430

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
5502002455MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1558901454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SELECT REHABILITATION, LLC",
            "address_2": "2600 COMPASS ROAD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "877-787-3430",
            "fax_number": "847-441-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAMARITAS SENIOR LIVING",
            "address_2": "460 PEARL STREET",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "49601",
            "telephone_number": "231-775-0101",
            "fax_number": "231-775-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEARNS",
        "first_name": "DIANE",
        "middle_name": "LYN",
        "credential": "C,P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502002455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.