Lisa Jill Vandiemen, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP119904 Issued in TX

Practice address

615 Clinic Dr
Longview, TX 75605-5172

Phone

(903) 571-4656

Fax

(903) 881-1994

NPI assigned

Feb 1, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Lisa Jill Van Diemen Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Special Health Resources for Texas, IncorporatedGroup PAC ID 1355326158, shared by 11 NPIs, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisa.vandiemen@wchcl.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

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.

• Diagnostic Clinic of Longview PA

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1386638468
  NPD (past)
• Special Health Resources for Texas, Incorporated

  dba Longview Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1043209919
  NPD (past)

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1396041885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12197 CROSS FENCE TRL",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757064241",
            "telephone_number": "903-571-4656",
            "fax_number": "903-881-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 CLINIC DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055172",
            "telephone_number": "903-571-4656",
            "fax_number": "903-881-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIEMEN",
        "first_name": "LISA",
        "middle_name": "JILL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-01",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "684452",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP119904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "VAN DIEMEN",
            "middle_name": "JILL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Donald Joe Van Sandt, O.D.
• Stephanie Vana
• Jamie G. Vanbiber, MAMFT, LPC
• Shonna Vance, LCSW
• Matthew T Vander Woude, D.O.
• Paige Therese Vanmeter
• Mary Lynn Vassar, RD
• Christin Vaughan, PHARMD
• David M Vaughan, RPH
• Yashashree A Vegi, MD

• Psychiatric/Mental Health Nurse Practitioner in Longview, TX
• Providers in Longview, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.