Active NPI
James Jerome Diehl, M.D.
- Plastic Surgery Physician
- Eden Prairie, MN
National Provider Identifier
1184994501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 15978
- Practice address
- 10530 W Riverview Dr
Eden Prairie, MN 55347-4921 - Phone
- (952) 944-0384
- NPI assigned
- Jan 2, 2012
- Last updated
- Jan 2, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 15978 | MN | Primary |
Addresses
Primary practice location
10530 W Riverview Dr
Eden Prairie, MN 55347-4921
Mailing address
10530 W Riverview Dr
Eden Prairie, MN 55347-4921
Phone (952) 944-0384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15978 | MN | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325462400000",
"number": "1184994501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10530 W RIVERVIEW DR",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553474921",
"telephone_number": "952-944-0384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10530 W RIVERVIEW DR",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553474921",
"telephone_number": "952-944-0384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEHL",
"first_name": "JAMES",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-02",
"last_updated": "2012-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MN",
"license": "15978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.