Active NPI
Diane M Drevs, PA-C
- Medical Physician Assistant
- South Sioux City, NE
National Provider Identifier
1518990928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 696
- Practice address
- 3250 Plaza Dr
South Sioux City, NE 68776-3144 - Phone
- (402) 412-4220
- Fax
- (402) 494-1365
- NPI assigned
- Jul 9, 2006
- Last updated
- Mar 8, 2011
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 696 | NE | Primary |
Addresses
Primary practice location
3250 Plaza Dr
South Sioux City, NE 68776-3144
Mailing address
814 Pierce St
Suite 102
Sioux City, IA 51101-1058
Phone (712) 226-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13646 | Other | IA | WELLMARK |
Other names 1
- Diane M Erickson
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14719 | NE | MD | Mental Health Counselor |
| 696 | NE | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Health Resources | Medical | Past | Accepting new patients |
| Family Health Care of Siouxland LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Family Health Care Moville Clinic
- Family Medicine Physician
- Moville, IA
- NPI 1720278278
-
dba St Lukes Clinic Network
- Family Medicine Physician
- Sioux City, IA
- NPI 1528001492
Medical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299542400000",
"number": "1518990928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 PIERCE ST",
"address_2": "SUITE 102",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511011058",
"telephone_number": "712-226-2600",
"fax_number": "712-226-2605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 PLAZA DR",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687763144",
"telephone_number": "402-412-4220",
"fax_number": "402-494-1365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREVS",
"first_name": "DIANE",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2011-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NE",
"license": "696",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "13646",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DIANE",
"last_name": "ERICKSON",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.