Paul G Diederich, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

04-33478 Issued in KS

Practice address

10787 Nall Ave
Ste. 310
Overland Park, KS 66211-1375

Phone

(913) 945-6900

Fax

(913) 945-6970

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Medical Plaza Consultants, P.C.

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1538149323
  NPD

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1003896895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SHAWNEE MISSION PARKWAY",
            "address_2": "MEDICAL ADMINISTRATIVE SERVICES OF KU STE. 312",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662050000",
            "telephone_number": "913-945-5614",
            "fax_number": "913-945-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10787 NALL AVE",
            "address_2": "STE. 310",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111375",
            "telephone_number": "913-945-6900",
            "fax_number": "913-945-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDERICH",
        "first_name": "PAUL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R9699",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-33478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DI201088119",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Faye Dickson, PA
• Marissa A Dickson, PHARMD
• Jeremy W Didier, LMSW
• Allison Diebolt, OTR/L
• Anna Diec
• Rhett Diefendorf
• Jackson L Diel, DPT
• Jessica Marie Diestel
• Cassie Christine Dietrich, M.D.
• Douglas K. Dietrich, R.PH.

• Internal Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.