Trent Walker Dietsche, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2020036425 Issued in MO

Practice address

4807 Country Club Rd
Winston Salem, NC 27104-4503

Phone

(336) 245-8159

NPI assigned

May 1, 2018

Last updated

Mar 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, MO, NC, FL, AL5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Doctors Own Urgent Care

  • Urgent Care Clinic/Center
  • Winston Salem, NC
  • NPI 1023734803
  Medicare reassignment NPD Authorized official
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  FL, NC, SC

  Medicare reassignment NPD
• Mercy St. Francis Hospital

  • Critical Access Hospital
  • Mountain View, MO
  • NPI 1023053477
  Medicare reassignment
• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL, MO

  Medicare reassignment

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1164910501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 COUNTRY CLUB RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044503",
            "telephone_number": "336-245-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 COUNTRY CLUB RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044503",
            "telephone_number": "336-245-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETSCHE",
        "first_name": "TRENT",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2020036425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3000 Saint Matthews Rd",
            "city": "Orangeburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291181442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dickson Clinic of Chiropractic PA
• Felicitas Lourdes Dickson, M.D.
• George Dicola I, ST
• Kevin Charles Diehl, MD
• Lucas Alan Dietrich, PA
• Digestive Health Specialists, PA
• Digestive Health Specialists, PA
• Ashley Diggs
• Carliss Diggs
• Supreme Essence Diggs

• Family Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.