DR. RYAN RICHARD DIETLEIN, D.P.T - NPI NUMBER 1003253352

Summary

Provider Name: DR. RYAN RICHARD DIETLEIN, D.P.T

NPI Number: 1003253352

Clasification: Physical Therapist (225100000X)

Organization: MIDLAND PHYSICAL THERAPY INC.

Address:
203 DILTS RD
ITHACA, MI
ZIP 48847

Phone Number: (989) 875-2266



Detailed Information

DR. Ryan Richard Dietlein, D.P.T is a physical therapist in Ithaca, MI with 2 years of experience. The provider is (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT�s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient�s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. The assigned NPI number for this provider is 1003253352 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

203 DILTS RD
ITHACA, MI
ZIP 48847-475
Phone: (989) 875-2266
Fax: (989) 875-2225

The enumeration date for this NPI number is 5/28/2013 and was last updated on 5/28/2013.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 225100000X Physical Therapist 5501016312 MI Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 5501016312 OTHER MI LICENSE

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1003253352 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name DIETLEIN The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name RYAN The first name of the provider, if the provider is an individual.
5 Provider Middle Name RICHARD The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text D.P.T The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 203 DILTS RD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name ITHACA The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name MI The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 488479475 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 9898752266 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 9898752225 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 5/28/2013 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 5/28/2013 The date that a record was last updated or changed.
17 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 225100000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 5501016312 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 MI The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 5501016312 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier State 1 MI
25 Other Provider Identifier Issuer 1 LICENSE
26 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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