Eric Diller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2167 Issued in MN

Practice address

640 Jackson St
Inpatient Rehab Unit
St Paul, MN 55101

Phone

(651) 254-3456

NPI assigned

Dec 10, 2020

Sex

Male

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1881290138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12097 GANTRY CT",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246200",
            "telephone_number": "612-357-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "address_2": "INPATIENT REHAB UNIT",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLER",
        "first_name": "ERIC",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "2167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lee Digolo, MA
• Jeff Ray Digre, PHARM D
• Nevin D Dikel, MD
• Sibel Sabiha Dikmen, MD
• Ann Dillard
• Bonnie J Dillon, MD
• Rosen K Dimitrov, M.D.
• Randa Dincer, M.D.
• Christine Ding, M.D.
• Shukri Mohamud Dini

• Physical Therapy Assistant in St Paul, MN
• Providers in St Paul, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.