Dianna Marie Prokupek, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G087587 Issued in IA

Practice address

1408 East 10TH St
Atlantic, IA 50022

Phone

(712) 243-2606

Fax

(712) 243-2688

NPI assigned

Feb 2, 2006

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

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Heartland Family Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Council Bluffs, IA
  • NPI 1972343184

  IA

  Medicare reassignment NPD
• Heartland Family Service

  • Multi-Specialty Clinic/Center
  • Council Bluffs, IA
  • NPI 1447742036
  NPD
• Heartland Family Service

  • Professional Counselor
  • Council Bluffs, IA
  • NPI 1710136841
  NPD

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1194797449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 EAST 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "50022",
            "telephone_number": "712-243-2606",
            "fax_number": "712-243-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 EAST 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "50022",
            "telephone_number": "712-243-2606",
            "fax_number": "712-243-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKUPEK",
        "first_name": "DIANNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G087587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0464800",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Ray Petersen, D.D.S
• Shannon Peterson, DNP, ARNP
• Kieu Diem Pham
• Physician Management Services of Iowa, LLC
• Physiotherapy Associates Inc
• Justina R Reeves, TCADC
• Renal Treatment Centers Illinois Inc
• Rex Pharmacy Inc
• Rex Pharmacy Inc
• Jessica Richter, LMHC

• All providers in Atlantic, IA
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.