Stacia Nissen Dierks

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

073738 Issued in IA

Practice address

3200 Westown Pkwy
West Des Moines, IA 50266-1110

Phone

(515) 276-1212

NPI assigned

Aug 7, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1376952036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 34TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105237",
            "telephone_number": "515-571-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661110",
            "telephone_number": "515-276-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKS",
        "first_name": "STACIA",
        "middle_name": "NISSEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "073738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Dickey
• Christopher Dickinson, DO
• Laura L Dickinson
• Benjamin M Diedrick, DPT
• Jordan Dielmann, ATC
• Deborah Emily Dietrich, D.D.S.
• Jeffrey Joseph Dietzenbach, M.D.
• Tera Nicole Diewold, PA
• Rebecca Anne Dillman, PA-C
• Megan Elizabeth Dillon, MS, CCC-SLP

• Physical Therapy Assistant in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.