Active NPI
Klaus D Diem, MD
- Gynecology Physician
- Verona, WI
National Provider Identifier
1083680151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 19614
- Practice address
- 1609 Red Tail Dr
Verona, WI 53593-7931 - Phone
- (608) 845-5655
- NPI assigned
- Feb 27, 2006
- Last updated
- Apr 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 19614 | WI | |
| Gynecology Physician | 207VG0400X | 19614 | WI | Primary |
Addresses
Primary practice location
1609 Red Tail Dr
Verona, WI 53593-7931
Mailing address
1609 Red Tail Dr
Verona, WI 53593-7931
Phone (608) 845-5655
Other practice location 1
20 S Park
Madison, WI 53715
Phone (608) 287-2830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19614 | WI | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1083680151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 RED TAIL DR",
"city": "VERONA",
"state": "WI",
"postal_code": "535937931",
"telephone_number": "608-845-5655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 RED TAIL DR",
"city": "VERONA",
"state": "WI",
"postal_code": "535937931",
"telephone_number": "608-845-5655"
}
],
"practiceLocations": [
{
"address_1": "20 S Park",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "53715",
"country_code": "US",
"telephone_number": "608-287-2830",
"fax_number": "608-287-2845",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIEM",
"first_name": "KLAUS",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-27",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WI",
"license": "19614",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "WI",
"license": "19614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Verona, WI
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- Dean Retail Services, Inc. (SSm Health Davis Duehr Dean Eye Care)
- Abigail Densing, PHARMD
- Janelle Derose, RN
- Kathleen A Desantes, MD
- Michelle Alexandra Dimartino, OTR
- Krista Dopf, PA C
- Dylan Charles Downs, D.M.D.
- Dr. David a. Besley, DDS, Inc
- Dr. Laura Week Chiropractic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.