Katherine Dietzel, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT010762 Issued in GA

Practice address

2500 Dallas Hwy SW Ste 520
Marietta, GA 30064-2664

Phone

(678) 383-1696

Fax

(678) 681-9106

NPI assigned

Feb 14, 2020

Last updated

Feb 14, 2020By 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 GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Georgia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1245826999
  Medicare reassignment

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1598398901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677285",
            "telephone_number": "615-373-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 DALLAS HWY SW STE 520",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642664",
            "telephone_number": "678-383-1696",
            "fax_number": "678-681-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZEL",
        "first_name": "KATHERINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetrius Leutrel Dicks, M.D.
• Alexa Anne Dickson, FNP
• Mark W Diehl, M.D.
• Sandra Ann Diehl, MD
• Danielle Ann Dietrich, DC
• Jacqueline Lydia Difelice, PA-C
• Erin Diffenderffer, PT
• Digestive Healthcare of Ga, P.C.
• Digital Radiographic Diagnostics, LLC
• Miranda G Dillard-Whymss, LMSW

• Physical Therapist in Marietta, GA
• Providers in Marietta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.