Active NPI
John Leslie Diels, P.T.
- Physical Therapist
- Waukesha, WI
National Provider Identifier
1780814186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2139-024
- Practice address
- 1810 Kensington Dr
Waukesha, WI 53188-5616 - Phone
- (262) 548-1400
- NPI assigned
- Jul 20, 2009
- Sex
- Male
- 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 | 2139-024 | WI | Primary |
Addresses
Primary practice location
1810 Kensington Dr
Waukesha, WI 53188-5616
Mailing address
2350 County Road Ab
MC Farland, WI 53558-9760
Phone (608) 335-8913
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2139-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248048000000",
"number": "1780814186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 COUNTY ROAD AB",
"city": "MC FARLAND",
"state": "WI",
"postal_code": "535589760",
"telephone_number": "608-335-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1810 KENSINGTON DR",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885616",
"telephone_number": "262-548-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIELS",
"first_name": "JOHN",
"middle_name": "LESLIE",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-20",
"last_updated": "2009-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "2139-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.