Jonnie Diederich, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A-0728 Issued in NV

Practice address

1575 Robb Dr
Reno, NV 89523-3746

Phone

(775) 827-3777

Fax

(775) 827-1013

NPI assigned

Oct 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1750786406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SUMMIT RIDGE DR",
            "address_2": "#5321",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895239014",
            "telephone_number": "775-827-3777",
            "fax_number": "775-827-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 ROBB DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895233746",
            "telephone_number": "775-827-3777",
            "fax_number": "775-827-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDERICH",
        "first_name": "JONNIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-0728",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1954-19",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "0013299",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "09039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Ludwick Dickson
• Erika Dickson
• Joshua Kent Dickson
• Michael Todd Dicus, D.M.D.
• Eric Diddy, PH.D.
• David L. Diedrichsen, M.D.
• Aaron Dieringer, MD
• Geoffrey Mahlon Dieringer, LMSW, CSW-I
• Paul E Dieringer, M.D.
• Deborah Anne Dieter

• Physical Therapy Assistant in Reno, NV
• Providers in Reno, NV by specialty
• Physical Therapy Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.