Active NPI
Diane Mary Mueller, NP
- Nurse Practitioner
- Kalispell, MT
National Provider Identifier
1437185329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 104274
- Practice address
- 310 Sunnyview LN
Kalispell, MT 59901-3129 - Phone
- (406) 751-5310
- NPI assigned
- Jun 23, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 990307 | CO | |
| Nurse Practitioner | 363L00000X | 089766 | MO | |
| Family Nurse Practitioner | 363LF0000X | 45806 | KS | |
| Nurse Practitioner | 363L00000X | 104274 | MT | Primary |
Addresses
Primary practice location
310 Sunnyview LN
Kalispell, MT 59901-3129
Mailing address
310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-5310
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100344220B | Medicaid | KS | |
| 1437185329 | Medicaid | NE | |
| 1437185329 | Medicaid | MT | |
| 30422558 | Medicaid | CO | |
| 1760794481 | Medicaid | ID | |
| 424669018 | Medicaid | MO | |
| 71581570 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 990307 | CO | MD | Nurse Practitioner |
| 089766 | MO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson City Medical Group, P.C. | Current | Accepting new patients | |
| Jefferson City Medical Group, P.C. | Current | Accepting new patients |
Locations
1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771
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.
-
- Hematology & Oncology Physician
- Jefferson City, MO
- NPI 1215093257
-
- Clinical Medical Laboratory
- Jefferson City, MO
- NPI 1811292105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503360000000",
"number": "1437185329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 SUNNYVIEW LN",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599013129",
"telephone_number": "406-751-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 SUNNYVIEW LN",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599013129",
"telephone_number": "406-751-5310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "DIANE",
"middle_name": "MARY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2017-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "990307",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "089766",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KS",
"license": "45806",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MT",
"license": "104274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100344220B",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437185329",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437185329",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30422558",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1760794481",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "424669018",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71581570",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.