Active NPI
Kevin Lee Dibert
- Certified Registered Nurse Anesthetist
- Delmont, PA
National Provider Identifier
1588091565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 101293
- Practice address
- 259 Rose CT N
Delmont, PA 15626-1555 - Phone
- (724) 787-5708
- NPI assigned
- Oct 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | RN529489L | PA | |
| Certified Registered Nurse Anesthetist | 367500000X | 101293 | PA | Primary |
Addresses
Primary practice location
259 Rose CT N
Delmont, PA 15626-1555
Mailing address
259 Rose CT N
Delmont, PA 15626-1555
Phone (724) 787-5708
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
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101293 | PA | MD | Certified Registered Nurse Anesthetist |
| RN529489L | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388707200000",
"number": "1588091565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 ROSE CT N",
"city": "DELMONT",
"state": "PA",
"postal_code": "156261555",
"telephone_number": "724-787-5708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 ROSE CT N",
"city": "DELMONT",
"state": "PA",
"postal_code": "156261555",
"telephone_number": "724-787-5708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBERT",
"first_name": "KEVIN",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-04",
"last_updated": "2014-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "RN529489L",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "101293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delmont, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.