Active NPI
Candace Lee Diercks
- Homemaker
- Waterloo, IA
National Provider Identifier
1497026512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 1844 W Ridgeway Ave
Waterloo, IA 50701-4546 - Phone
- (319) 235-5999
- NPI assigned
- Jan 20, 2012
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
1844 W Ridgeway Ave
Waterloo, IA 50701-4546
Mailing address
1844 W Ridgeway Ave
Waterloo, IA 50701-4546
Phone (319) 235-5999
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diercks Senior Care LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Home Instead Senior Care
- In Home Supportive Care Agency
- Waterloo, IA
- NPI 1962864926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1497026512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1844 W RIDGEWAY AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507014546",
"telephone_number": "319-235-5999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1844 W RIDGEWAY AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507014546",
"telephone_number": "319-235-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIERCKS",
"first_name": "CANDACE",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-20",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.