Megan Dietz

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

5501301829 Issued in MI

Practice address

17141 Kercheval Ave
Grosse Pointe, MI 48230-1660

Phone

(313) 642-4980

NPI assigned

Sep 11, 2023

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1861279176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29385 PALOMINO DR",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933564",
            "telephone_number": "231-883-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17141 KERCHEVAL AVE",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301660",
            "telephone_number": "313-642-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501301829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Elizabeth Tudor Dawson
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• Marc Anthony Digrande, DPM
• Brian Matthew Dimmer, M.D.
• Steven Dion
• Docsmile Dental Center

• Physical Medicine & Rehabilitation Physician in Grosse Pointe, MI
• Providers in Grosse Pointe, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.