Individual provider Active NPI

Denna Louise Dietrich, NP

  • Acute Care Nurse Practitioner
  • Fairfield, OH
National Provider Identifier
1174522650
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.07066 Issued in OH
Practice address
3000 Mack Rd
Ste 100
Fairfield, OH 45014-5335
Phone
(513) 751-4222
Fax
(513) 824-3023
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN242532 OH
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.07066 OH Primary

Addresses

Primary practice location

3000 Mack Rd
Ste 100
Fairfield, OH 45014-5335

Mailing address

3000 Mack Rd
Ste 100
Fairfield, OH 45014-5335
Phone (513) 751-4222

Other identifiers 1

IdentifierTypeStateIssuer
2593073MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050721000516 OH Practitioner - Nurse Practitioner 6204863236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Cincinnati Specialty Care LLCGroup PAC ID 3971907759, 343 clinicians

Practice addresses (Care Compare)

3000 Mack Rd
Suite 100
Fairfield, OH 45014-5335
Phone (513) 751-4222

Hospital & facility affiliations

  • Mercy Health-Anderson Hospital Hospital, Cincinnati, OH, CCN 360001
  • Mercy Health - Clermont Hospital Hospital, Batavia, OH, CCN 360236
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.07066OHMDAcute Care Nurse Practitioner
RN242532OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Miami Valley Cardiologists Inc. Past Accepting new patients

Locations

7502 State Rd
Ste 2210A
Cincinnati, OH 45255
Phone (513) 624-2070

7502 State Rd
Ste 2210
Cincinnati, OH 45255
Phone (513) 624-2070

3000 Mack Rd
Ste 100
Fairfield, OH 45014

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: ddietrich4007@direct.bsmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1174522650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "address_2": "STE 100",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-751-4222",
            "fax_number": "513-824-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "address_2": "STE 100",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-751-4222",
            "fax_number": "513-824-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "DENNA",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "RN242532",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.07066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2593073",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.