Active NPI
Britttany Elaine Dietz, PTA
- Physical Therapy Assistant
- Fort George G Meade, MD
National Provider Identifier
1639646623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A5162
- Practice address
- 2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081 - Phone
- (301) 677-8796
- NPI assigned
- Oct 27, 2018
- Last updated
- Jul 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE011565 | PA | |
| Physical Therapy Assistant | 225200000X | A5162 | MD | Primary |
Addresses
Primary practice location
2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Mailing address
2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Phone (301) 677-8796
Other practice location 1
2990 Carlisle Pike
New Oxford, PA 17350-9582
Phone (717) 624-2161
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
| License | State | Type | Specialty |
|---|---|---|---|
| A5162 | MD | MD | Physical Therapy Assistant |
| TE011565 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1639646623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "207557081",
"telephone_number": "301-677-8796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "207557081",
"telephone_number": "301-677-8796"
}
],
"practiceLocations": [
{
"address_1": "2990 Carlisle Pike",
"address_purpose": "LOCATION",
"city": "New Oxford",
"state": "PA",
"postal_code": "173509582",
"country_code": "US",
"telephone_number": "717-624-2161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIETZ",
"first_name": "BRITTTANY",
"middle_name": "ELAINE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-27",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE011565",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A5162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort George G Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.