Active NPI
Elizabeth Anne Dieringer, MPT
- Physical Therapist
- West Bend, WI
National Provider Identifier
1760608376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10428-024
- Practice address
- 1110 Gateway CT
West Bend, WI 53095-8539 - Phone
- (262) 306-6100
- Fax
- (262) 306-6105
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10428-024 | WI | Primary |
Addresses
Primary practice location
1110 Gateway CT
West Bend, WI 53095-8539
Mailing address
845 Cardinal Dr
Cedarburg, WI 53012-9404
Phone (262) 377-2866
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | edieringer13531@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10428-024 | WI | MD | Physical Therapist |
Interoperability endpoints
- edieringer13531@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1760608376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 CARDINAL DR",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530129404",
"telephone_number": "262-377-2866",
"fax_number": "262-306-6105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 GATEWAY CT",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530958539",
"telephone_number": "262-306-6100",
"fax_number": "262-306-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIERINGER",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10428-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "edieringer13531@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1110 Gateway Ct",
"city": "West Bend",
"state": "WI",
"country_code": "US",
"postal_code": "530958539",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1110 Gateway Ct",
"city": "West Bend",
"state": "WI",
"country_code": "US",
"postal_code": "530958539",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.