Kimberly S Diltz, CNS

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

NS04904 Issued in OH

Practice address

3130 N County Road 25a
Ste 103
Troy, OH 45373-1337

Phone

(937) 773-0428

Fax

(937) 773-0439

NPI assigned

Mar 9, 2007

Last updated

Nov 18, 2013By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

Practice roles

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.

• Upper Valley Professional Corporation

  • Family Medicine Physician
  • Troy, OH
  • NPI 1407872518
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1255463048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "address_2": "STE 103",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-773-0428",
            "fax_number": "937-773-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "address_2": "STE 103",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-773-0428",
            "fax_number": "937-773-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILTZ",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OH",
            "license": "NS04904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "311176809028",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2494877",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia A Dicicco, DO
• Michelle Dickman, MS, LPC
• Digestive Specialty Care Inc
• Anthony Fedele Digiannantonio, M.D.
• Summer Dilbone
• Daniel John Dilworth, MD
• Marc Dilworth
• Thomas Joseph Dilworth
• Gina Diodati
• Deashone V Dixon

• Clinical Nurse Specialist in Troy, OH
• Providers in Troy, OH by specialty
• Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.