Diedre Pulver, RD, LD

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

37003609A Issued in IN

Practice address

1234 E Dupont Rd Ste 6
Fort Wayne, IN 46825-1545

Phone

(260) 425-6390

Fax

(260) 425-6395

NPI assigned

Jan 6, 2023

Last updated

Aug 30, 2023By 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

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpulver522671@direct.parkviewexchange.com

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.

• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment NPD
• Parkview Health System,Inc.

  dba Parkview Physicians Group

  • Gastroenterology Physician
  • Fort Wayne, IN
  • NPI 1437461449
  NPD

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1174237952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 E DUPONT RD STE 6",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-425-6390",
            "fax_number": "260-425-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULVER",
        "first_name": "DIEDRE",
        "name_prefix": "Mrs.",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "IN",
            "license": "37003609A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpulver522671@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1234 E DuPont Rd Ste 6",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468251545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1234 E DuPont Rd Ste 6",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468251545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1234 E DuPont Rd Ste 6",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468251545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bradley Jon Pulfer, D.D.S.
• Sheryleen Derede Pulfer, D.D.S
• Jyostna Deepika Pulla, MD
• Niyota Pulliam
• Pulmonary Asthma & Allergy Consults
• Melissa G Pulver, RN
• Stacey Renee Pulver, MSN FNP-C
• Taryn Pulver, LMHCA
• ,Birute L Pumputis, MD
• Purdue University (IPFW Dental Hygiene Clinic)

• Obesity and Weight Management Nutrition Registered Dietitian in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.