Jenny Dietz

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G155693 Issued in IA

Practice address

602 8TH St SW
Altoona, IA 50009-2301

Phone

(515) 414-1830

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1053964452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 241ST AVE",
            "city": "HARMONY",
            "state": "MN",
            "postal_code": "559396515",
            "telephone_number": "260-265-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 8TH ST SW",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500092301",
            "telephone_number": "515-414-1830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11809 241st Ave",
            "address_purpose": "LOCATION",
            "city": "Harmony",
            "state": "MN",
            "postal_code": "559396515",
            "country_code": "US",
            "telephone_number": "719-749-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "JENNY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2024-05-04",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G155693",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "233383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Ann De Kruyff, DC
• Rose Marie Delateur
• Katie Denker, DPT
• Detrick Mental Health Counseling Services
• Lacey Dettmering, D.C.
• Kari M Disney
• Robin Renee Doan, BC-HIS
• Doctorsnow Walk-in Care, L.C.
• Todd J Dodson, MPT
• Ryan J Domeyer, PT

• Psychiatric/Mental Health Nurse Practitioner in Altoona, IA
• Providers in Altoona, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.