Diane Bakke Tennant, PT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

62002602 Issued in NY

Practice address

60 Central Ave
Cortland, NY 13045-2795

Phone

(607) 756-3401

NPI assigned

May 28, 2010

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

Other names 1

• Diane Florence Bakke Former name

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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1679892624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 LYNCOURT DRIVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-756-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CENTRAL AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452795",
            "telephone_number": "607-756-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "DIANE",
        "middle_name": "BAKKE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "62002602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "BAKKE",
            "middle_name": "FLORENCE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Talbot
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• Alan Taylor, MS, CRC, CASAC, LPC
• Amy Kathryn Taylor
• Breanne Louise Teeter, M.S., CCC-SLP
• Eric J Tenorio, CASAC LEVEL 2
• Genevieve Thacher, LMSW
• The Doors of Perception LCSW, PLLC
• The Golub Corporation
• The Homeville Museum Inc

• Community Health Worker in Cortland, NY
• Providers in Cortland, NY by specialty
• Community Health Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.