Gillian Diederich Wenzke, AG-ACNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP.019493 Issued in OH

Practice address

500 Lincoln Park Blvd
Suite 100
Dayton, OH 45429-3492

Phone

(937) 222-3118

Fax

(937) 222-1436

NPI assigned

Jul 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gillian Margaret Diederich Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Wright State University Boonshoft School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renal Physicians IncGroup PAC ID 5193624161, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renal Physicians Inc

  • Nephrology Physician
  • Kettering, OH
  • NPI 1962486316
  Medicare reassignment Care Compare group NPD
• Nephrology Associates of Dayton Inc

  • Nephrology Physician
  • Dayton, OH
  • NPI 1184698458
  Medicare reassignment NPD

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

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1669925673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454293492",
            "telephone_number": "937-222-3118",
            "fax_number": "937-222-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454293492",
            "telephone_number": "937-222-3118",
            "fax_number": "937-222-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZKE",
        "first_name": "GILLIAN",
        "middle_name": "DIEDERICH",
        "name_prefix": "Mrs.",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "CNP.019493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GILLIAN",
            "last_name": "DIEDERICH",
            "middle_name": "MARGARET",
            "credential": "AG-ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zachary Wenker, M.D.
• Amy Wennerstrom, PT 9518
• Kathleen Wenning, ACNP
• Mark Scott Wenzel, DDS
• Christina Cho Wenzell, MD
• Stephen C. Wenzke, MD
• Larry W Weprin, M.D.
• Emily Kay Werlein, M.ED., L.P.C.C.
• Susan Kathleen Werner Huck, R.PH.
• Clarissa Werner, SWT

• Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.