Diane Michele Bickle, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP2757 Issued in AZ

Practice address

2202 N Stockton Hill Rd Ste 100
Kingman, AZ 86401-4622

Phone

(928) 681-8706

Fax

(928) 861-8707

NPI assigned

Oct 29, 2008

Last updated

Apr 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diane M Smith Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bickle.diane@direct.azkrmc.md

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.

• Kingman Healthcare, Inc

  dba Kingman Regional Medical Center

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Medicare reassignment NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787
  NPD
• Kingman Healthcare, Inc

  dba KRMC Community Pharmacy

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD
• Scottsdale Pediatrics and Pediatric Nephrology, PLLC

  dba Agave Pediatrics

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1629076518
  NPD (past)

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1124271598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 RAFTER B AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864017308",
            "telephone_number": "602-809-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N STOCKTON HILL RD STE 100",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014622",
            "telephone_number": "928-681-8706",
            "fax_number": "928-861-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKLE",
        "first_name": "DIANE",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP2757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596098",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "SMITH",
            "middle_name": "M",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Annika Jeanette Bergeson, MSN, FNP-C
• Jeffrey Parke Bergeson, O.D.
• Best Hospice LLC (Harmony Hospice of Arizona)
• Better Balance Physical Therapy & Wellness
• BHSM Rehabilitation, LLC (Banner Physical Therapy)
• Bio-Medical Applications of Arizona, LLC (Fresenius Medical Care Kingman)
• Jeremy Bird
• Erin E. Black, FNP-C
• Jettie A. Blanton, MSW, LCSW
• David M Bleiler, D.C.

• Pediatric Nurse Practitioner in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.