Jamie Diesetlhorst

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.005560 Issued in IL

Practice address

14905 Windy Hill Road
Bunker Hill, IL 62014-3003

Phone

(618) 585-4546

NPI assigned

May 25, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1588957443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14905 WINDY HILL ROAD",
            "city": "BUNKER HILL",
            "state": "IL",
            "postal_code": "62014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14905 WINDY HILL ROAD",
            "city": "BUNKER HILL",
            "state": "IL",
            "postal_code": "620143003",
            "telephone_number": "618-585-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIESETLHORST",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bunker Hill Community Unit No 8
• Bunker Hill Medical Clinic
• Care in the Heart of Home
• Darlene Louise Clark, D.M.D.
• Elizabeth L Conner, PHD CCC SLP
• Emma Gansz
• Jones Chiropractic and Physical Therapy LTD
• Daniel M. Jones, D.C.
• Richard A Jones, D.C.
• Morgan Mave Kinder, DC

• Physical Therapy Assistant in Bunker Hill, IL
• Providers in Bunker Hill, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.