Diedra M Ahlert, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2020022571 Issued in MO

Practice address

1320 Lexington Dr
Collinsville, IL 62234-4348

Phone

(618) 444-3351

NPI assigned

Jul 28, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2511/brand/1/csg/1/fhir/r4
• Direct secure messaging: diedra.ahlert.1@2511.direct.athenahealth.com

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.

• Pediatric Healthcare Unlimited

  • Pediatrics Physician
  • Alton, IL
  • NPI 1982766390
  NPD (past)
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • O Fallon, IL
  • NPI 1477076263
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1508475294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LEXINGTON DR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344348",
            "telephone_number": "618-444-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LEXINGTON DR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344348",
            "telephone_number": "618-444-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLERT",
        "first_name": "DIEDRA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.021680",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2020022571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 3F Vision LLC
• Ace Physical Therapy and Rehab Specialists LLC
• Adapt of Illinois, Inc.
• Aging Well Health Care, LLC
• Makin Uddin Ahmed, MD
• American Homepatient, Inc.
• Kevin Wayne Ames, DVM
• Apex Physical Therapy, LLC
• Apria Healthcare LLC

• All providers in Collinsville, IL
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.