Brian David Diaz, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P8453 Issued in NC

Practice address

4221 Garrett Rd Ste 2
Activedge Fitness & Sports Performance
Durham, NC 27707-3467

Phone

(919) 493-1204

Fax

(919) 493-1204

NPI assigned

Oct 11, 2006

Sex

Male

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Activedge Fitness and Sports Performance, Inc.

  • Orthopedic Physical Therapist
  • Durham, NC
  • NPI 1326474420
  NPD (past) Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609964717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 GARRETT RD STE 2",
            "address_2": "ACTIVEDGE FITNESS & SPORTS PERFORMANCE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073467",
            "telephone_number": "919-493-1204",
            "fax_number": "919-493-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 GARRETT RD STE 2",
            "address_2": "ACTIVEDGE FITNESS & SPORTS PERFORMANCE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073467",
            "telephone_number": "919-493-1204",
            "fax_number": "919-493-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P8453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Katharine Dias, PT, DPT, PCS
• Jenni Liane Dias, RDN, LDN, CDCES
• Ana Maria Diaz, LCSW-A
• Andrew Diaz, PHARMD
• Ashley Diaz, MD
• Drew Michael Diaz, MD
• Kendal Diaz, M.S. SLP
• Louis Dibernardo, M.D.
• Dice Chiropractic Wellness
• Dice Health PLLC

• Physical Therapist in Durham, NC
• Providers in Durham, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.