Active NPI
Jamie Dietrich, MPT
- Physical Therapist
- Middleburg, FL
National Provider Identifier
1932573672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13399
- Practice address
- 2583-3 County Road 220
Middleburg, FL 32068 - Phone
- (855) 242-6608
- Fax
- (855) 242-6609
- NPI assigned
- Nov 18, 2015
- Last updated
- Nov 18, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 13399 | FL | Primary |
Addresses
Primary practice location
2583-3 County Road 220
Middleburg, FL 32068
Mailing address
14167 Fennsbury Dr
Tampa, FL 33624-6978
Phone (813) 817-7199
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 |
|---|---|---|---|
| 13399 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447804800000",
"number": "1932573672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14167 FENNSBURY DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336246978",
"telephone_number": "813-817-7199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2583-3 COUNTY ROAD 220",
"city": "MIDDLEBURG",
"state": "FL",
"postal_code": "32068",
"telephone_number": "855-242-6608",
"fax_number": "855-242-6609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICH",
"first_name": "JAMIE",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-18",
"last_updated": "2015-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "13399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleburg, FL
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- Divine Purpose LLC (Divine Purpose)
- Nhan DO, D.O.
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- Doctors Inlet Pediatrics and Primary Care (Doctors Inlet Internal Medicine, Spine and Pain)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.