Nicole Marie Anna Dierking, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2011000036 Issued in MO

Practice address

1100 SE Century Dr
Ste D
Lees Summit, MO 64081-3284

Phone

(636) 253-0761

NPI assigned

Feb 24, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Balanced Spine and Rehabilitaion Chiropractic Center

  • Chiropractor
  • Blue Springs, MO
  • NPI 1093157463
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1003113226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SE CENTURY DR",
            "address_2": "STE D",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640813284",
            "telephone_number": "636-253-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SE CENTURY DR",
            "address_2": "STE D",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640813284",
            "telephone_number": "636-253-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKING",
        "first_name": "NICOLE",
        "middle_name": "MARIE ANNA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-24",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011000036",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Interventional Center LLC
• Jeimy Ysabel Diaz Johnson, DDS
• Loren Dickenson
• Erin M Dickey, FNP
• Michael J. Dieker, R.PH.
• Kylie B Digiacinto, CRNA
• John Dimaggio, D.C., M.S.
• Carl E Dippel, LCMFT
• Dissociative Associates, LLC
• Krishna Manej Divadeenam, MD

• All providers in Lees Summit, MO
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.