Individual provider Active NPI

Diane Jean Reetz, MS, P.T.

  • Physical Therapist
  • Marquette, MI
National Provider Identifier
1730348566
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005681 Issued in MI
Practice address
1414 W Fair Ave
Suite 190
Marquette, MI 49855-2675
Phone
(906) 225-1321
Fax
(906) 228-9371
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501005681 MI Primary

Addresses

Primary practice location

1414 W Fair Ave
Suite 190
Marquette, MI 49855-2675

Mailing address

1414 W Fair Ave
Suite 190
Marquette, MI 49855-2675
Phone (906) 225-1321

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5501005681MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1730348566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 190",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-1321",
            "fax_number": "906-228-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 190",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-1321",
            "fax_number": "906-228-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REETZ",
        "first_name": "DIANE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MS, P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.