Individual provider Active NPI

Emily S Dietz, ARNP

  • Family Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1023263464
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60024748 Issued in WA
Practice address
510 E Holland Ave
Spokane, WA 99218-1206
Phone
(509) 363-3100
Fax
(509) 363-0300
NPI assigned
Nov 26, 2008
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60024748 WA Primary

Addresses

Primary practice location

510 E Holland Ave
Spokane, WA 99218-1206

Mailing address

PO Box 808
Veradale, WA 99037-0808
Phone (509) 363-3100

Other identifiers 1

IdentifierTypeStateIssuer
AP60024748OtherWASTATE LICENSE

Other names 1

  • Emily S Mildes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090112000509 WA Practitioner - Nurse Practitioner 9234292657 Reassigns benefits to 1 organization
I20180205001875 ID Practitioner - Nurse Practitioner 9234292657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Mather, PC CurrentSince Nov 1, 2019 Accepting new patients
T Daniel Dibble MD PC CurrentSince Jan 4, 2021 Accepting new patients
T Daniel Dibble MD PC CurrentSince Jan 4, 2021 Accepting new patients
United Wound Healing Accountable Care Consultants PLLC Family CurrentSince Apr 1, 2022 Accepting new patients
Surgical Specialists of Spokane Past Accepting new patients
Department of Social Past Accepting new patients
Eastern State Hospital Pharmacy Past Accepting new patients

Locations

2913 5th Ave NE
Ste 101
Puyallup, WA 98372
Phone (253) 905-0646

1113 E Westview Ct
Spokane, WA 99218
Phone (208) 263-9757

510 E Holland Ave
Spokane, WA 99218
Phone (509) 363-3100

1123 N Evergreen Rd
Spokane Valley, WA 99216
Phone (509) 363-3100

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1023263464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 808",
            "city": "VERADALE",
            "state": "WA",
            "postal_code": "990370808",
            "telephone_number": "509-363-3100",
            "fax_number": "509-363-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E HOLLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181206",
            "telephone_number": "509-363-3100",
            "fax_number": "509-363-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "EMILY",
        "middle_name": "S",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-26",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60024748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP60024748",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "MILDES",
            "middle_name": "S",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.