Active NPI
Debra Diepenbrock
- Pediatrics Physician
- Wichita, KS
National Provider Identifier
1376166173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 94-10328
- Practice address
- 1010 N Kansas St Ste 3023
Wichita, KS 67214-3124 - Phone
- (316) 293-2665
- NPI assigned
- May 27, 2020
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 94-10328 | KS | Primary |
Addresses
Primary practice location
1010 N Kansas St Ste 3023
Wichita, KS 67214-3124
Mailing address
1010 N Kansas St Ste 3023
Wichita, KS 67214-3124
Phone (316) 293-2665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baldwin Area Medical Center, Inc. | Current | Accepting new patients | |
| Baldwin Area Medical Center Inc. | Current | Accepting new patients |
Locations
1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111
Interoperability endpoints
- ddiepenbrock660346@excellian.direct.allina.com
Organizations & group practices 2
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.
-
- Critical Access Hospital
- Baldwin, WI
- NPI 1467496133
-
- Clinic/Center
- Spring Valley, WI
- NPI 1164272324
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1376166173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 N KANSAS ST STE 3023",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143124",
"telephone_number": "316-293-2665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 N KANSAS ST STE 3023",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143124",
"telephone_number": "316-293-2665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEPENBROCK",
"first_name": "DEBRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "94-10328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.