Diane Iris Gonzales Mercado, R.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070016204 Issued in IL

Practice address

3290 N Ridge Rd
Suite 290
Ellicott City, MD 21043-3655

Phone

(410) 750-9006

NPI assigned

Mar 27, 2008

Last updated

Mar 27, 2008By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back in Action Holistic Health Center

  • Chiropractor
  • Rockford, IL
  • NPI 1063554343
  NPD (past)
• Northern Illinois Medical Group S. C.

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1861670101
  NPD (past)

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1720250061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD",
            "address_2": "SUITE 290",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433655",
            "telephone_number": "410-750-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD",
            "address_2": "SUITE 290",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433655",
            "telephone_number": "410-750-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "DIANE IRIS",
        "middle_name": "GONZALES",
        "name_prefix": "Ms.",
        "credential": "R.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melisa Pool, LCSW-C, LLC
• Kathryn Colleen Mello
• Kristin Lynn Mende, DPT
• Rachel Menditch, PSYD
• Michael Mentzel, D.M.A., M.A.
• Mercy Chiropractic and Rehabilitation Clinic, LLP
• Mercy Health Solutions LLC
• Mercy Health Solutions LLC
• Mercy Ijoma
• Mercy Ijoma-Family Health Connections

• Physical Therapist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.