Jill Denise Dierks, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TAP10109 Issued in AZ

Practice address

9947 W Happy Valley Rd Ste 104
Peoria, AZ 85383-1222

Phone

(623) 434-5748

Fax

(623) 566-9665

NPI assigned

May 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067
• Mercyone Oelwein Medical Center Hospital, Oelwein, IA, CCN 161338

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdierks3931284@direct.trinity-health.org

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.

• Covenant Medical Center Inc

  • Family Medicine Physician
  • Waterloo, IA
  • NPI 1548288160
  Medicare reassignment Care Compare group NPD
• Covenant Medical Center, Inc.

  • Customized Equipment (DME)
  • Evansdale, IA
  • NPI 1851141980
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Covenant Medical Center Inc

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1700827896
  Care Compare affiliation
• Mercy Hospital of Franciscan Sisters Inc

  • Critical Access Hospital
  • Oelwein, IA
  • NPI 1528009511
  Care Compare affiliation

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1609303379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 ROCK ISLAND RD",
            "city": "OELWEIN",
            "state": "IA",
            "postal_code": "506623102",
            "telephone_number": "319-283-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9947 W HAPPY VALLEY RD STE 104",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831222",
            "telephone_number": "623-434-5748",
            "fax_number": "623-566-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKS",
        "first_name": "JILL",
        "middle_name": "DENISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP10109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "N/A",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdierks@bchealth.org",
            "affiliation": "N",
            "endpointDescription": "Buchanan County Health Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2405 Rock Island Rd",
            "city": "Oelwein",
            "state": "IA",
            "country_code": "US",
            "postal_code": "506623102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anahi Diaz Enriquez
• Isabelle Allison Diaz
• Sharon Marie Dickinson, P.A.
• Elizabeth Anne Diedrich, F.N.P.
• Benjamin M Dieringer, PT,DPT
• Michael A Dietrich, PHARM.D., BCPS
• Digestive Health Clinic, PLLC
• Meghan Digiacomo, OTR/L
• Rosa N Dipaola
• Danielle Dipaolo, PSYD

• Family Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.