Active NPI
Vickie M Dietrich
- Acute Care Nurse Practitioner
- Cincinnati, OH
National Provider Identifier
1285058057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- COA 15312-NP
- Practice address
- 2139 Auburn Ave
Cincinnati, OH 45219-2906 - Phone
- (513) 585-3888
- Fax
- (513) 585-1375
- NPI assigned
- Feb 13, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | COA 15312-NP | OH | Primary |
Addresses
Primary practice location
2139 Auburn Ave
Cincinnati, OH 45219-2906
Mailing address
2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-3888
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160613002554 | OH | Order and Referring Only - Nurse Practitioner | 0648561142 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA 15312-NP | OH | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1285058057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2139 AUBURN AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192906",
"telephone_number": "513-585-3888",
"fax_number": "513-585-1375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2139 AUBURN AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192906",
"telephone_number": "513-585-3888",
"fax_number": "513-585-1375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICH",
"first_name": "VICKIE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-13",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OH",
"license": "COA 15312-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.