Andrew Dieckmann, PT, DPT, LAT, ATC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

6231 Issued in OK

Practice address

1700 S Broadway St Ste E
Moore, OK 73160-5302

Phone

(405) 735-8777

NPI assigned

Sep 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthopedic Spine & Sports Physical Therapy PLLC

  • Physical Therapist
  • Moore, OK
  • NPI 1316311293

  Orthopedic

  Medicare reassignment NPD
• Osspt NW Okc PLLC

  • Physical Therapy Clinic/Center
  • Oklahoma City, OK
  • NPI 1063130888

  Orthopedic

  Medicare reassignment NPD

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

{
    "created_epoch": "1538265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1821573478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14638 S KAW DR",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660624867",
            "telephone_number": "913-645-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S BROADWAY ST STE E",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605302",
            "telephone_number": "405-735-8777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14638 S Kaw Dr",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660624867",
            "country_code": "US",
            "telephone_number": "913-645-2348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIECKMANN",
        "first_name": "ANDREW",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-30",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2019026347",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OK",
            "license": "6231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Depot Orthodontics Moore, PLLC
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• Dentists of Moore and Orthodontics
• Areaunna Detweiler
• Orlando A Diaz, OD
• Mary Grace Difuntorum, APRN, FNP
• Ian Digby
• Leslie Dillard, LADC/ LPC CANDIDATES
• Distinctive Adolescent and Adult Guidance Counseling Services
• Cassidy DO, DC

• Orthopedic Physical Therapist in Moore, OK
• Providers in Moore, OK by specialty
• Orthopedic Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.