Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson Ray Diede, MAT, ATC

Individual provider Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1760054373

Jackson Ray Diede, MAT, ATC is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Sioux Falls, South Dakota. Licensed in South Dakota. Registered with an NPI since 2021.

Licensed in
SD
In the registry since
2021
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

See every abbreviation used in this directory →

Practice location Address checks out

810 E 23rd St
Sioux Falls, SD 57105-2135
Phone: (605) 331-5890
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X · Licence 0714 (SD)

Record details

NPI number1760054373
Entity typeIndividual (Type 1)
GenderMale
Credentials MAT , ATC
Sole proprietorNo
NPI enumeratedJuly 13, 2021
Last updated in NPPESJuly 13, 2021
Certification dateJuly 13, 2021