Diane G Wassum, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1602 Issued in NC

Practice address

101 E WT Harris Blvd
Suite 300
Charlotte, NC 28262-3485

Phone

(704) 548-5780

Fax

(704) 578-5876

NPI assigned

Aug 1, 2006

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

Other identifiers 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891701306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035814",
            "telephone_number": "704-355-4370",
            "fax_number": "704-355-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WT HARRIS BLVD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-548-5780",
            "fax_number": "704-578-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSUM",
        "first_name": "DIANE",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211897",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "079AY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Washington
• Tiona T. Washington, LPCA
• Francine Waskavitz, M.S.
• John Joseph Wassel, M.D.
• Ja'Monica Wasson
• Marianne L. Waterhouse, CRNA
• Waterlyn Medical Supply
• Brittany Madison Waters
• Laura Denise Waters
• Nicole McIntyre Waters, IBCLC

• Physical Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.