Ann Kilgore Diem, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717001358 Issued in VA

Practice address

14801 Chesdin Green Way
Chesterfield, VA 23838-3278

Phone

(714) 322-9761

NPI assigned

Mar 22, 2011

Last updated

Feb 13, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ann Carol Kilgore Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Balance Behavioral Health PLLCGroup PAC ID 8022333210, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Balance Behavioral Health, PLLC

  • Clinical Psychologist
  • Midlothian, VA
  • NPI 1912338914
  Medicare reassignment Care Compare group NPD
• Ephratah Health Group LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Henrico, VA
  • NPI 1740057751
  NPD (past)

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1447559919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14801 CHESDIN GREEN WAY",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238383278",
            "telephone_number": "714-322-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14801 CHESDIN GREEN WAY",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238383278",
            "telephone_number": "714-322-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEM",
        "first_name": "ANN",
        "middle_name": "KILGORE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001358",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 34408",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601048159",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "KILGORE",
            "middle_name": "CAROL",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Deshazo, LCSW
• Devoted Family Solutions, LLC
• Nancy K Dewire, S.L.P.
• Diamond Supportive Services of Virginia LLC
• Kymberli Diamond, LPC
• Bruce W Dillard, L.C.S.W.
• Raymond Dinunzio, D.P.T.
• Jennifer Dishner, LPC
• Divyne Health Adult Day Center
• Florise E Dock-Chung

• Marriage & Family Therapist in Chesterfield, VA
• Providers in Chesterfield, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.