Individual provider Active NPI

James Monroe Dieter III, D.C., N.P.-C

  • Family Nurse Practitioner
  • Pasadena, TX
National Provider Identifier
1114159142
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
776968 Issued in TX
Practice address
5010 Crenshaw Rd
Suite 130
Pasadena, TX 77505-3097
Phone
(281) 991-2200
Fax
(281) 991-7700
NPI assigned
Aug 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 11230 TX
Family Nurse Practitioner 363LF0000X 776968 TX Primary

Addresses

Primary practice location

5010 Crenshaw Rd
Suite 130
Pasadena, TX 77505-3097

Mailing address

5010 Crenshaw Rd
Suite 130
Pasadena, TX 77505-3097
Phone (281) 991-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000332 TX Practitioner - Nurse Practitioner 1759429269 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11230TXMDGeneral Practice Dentistry
776968TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Specialists, PLLC CurrentSince May 3, 2017 Accepting new patients
Interventional Pain Specialists, PLLC CurrentSince May 3, 2017 Accepting new patients
Principlemed Anesthesia, PLLC Current Accepting new patients
Aurum Toxicology LLC PastSince Mar 21, 2014 Accepting new patients
Argentum Toxicology LLC PastSince Jun 1, 2014 Accepting new patients

Locations

1021 61st St
Ste 200
Galveston, TX 77551
Phone (409) 740-6800

16840 Buccaneer Ln
Ste J
Houston, TX 77058
Phone (832) 932-5968

16840 Buccaneer Ln
Ste 202
Houston, TX 77058

5010 Crenshaw Rd
Ste 130
Pasadena, TX 77505
Phone (713) 299-7374

6243 Fairmont Pkwy
Ste 200
Pasadena, TX 77505
Phone (281) 241-6130

7111 Medical Center Dr
Ste 100
Texas City, TX 77591
Phone (832) 738-1836

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1249689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1114159142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 CRENSHAW RD",
            "address_2": "SUITE 130",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053097",
            "telephone_number": "281-991-2200",
            "fax_number": "281-991-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 CRENSHAW RD",
            "address_2": "SUITE 130",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053097",
            "telephone_number": "281-991-2200",
            "fax_number": "281-991-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETER",
        "first_name": "JAMES",
        "middle_name": "MONROE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C., N.P.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-08",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "TX",
            "license": "11230",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "776968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.