NPIMap

Individual provider Active NPI

Elyse L Diewald, FNP-C

  • Family Nurse Practitioner
  • Laporte, CO
National Provider Identifier
1679200497
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0997806-NP Issued in CO
Practice address
3817 W County Road 54G
Laporte, CO 80535-9360
Phone
(970) 472-2001
NPI assigned
Aug 2, 2022
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0997806-NP CO Primary

Addresses

Primary practice location

3817 W County Road 54G
Laporte, CO 80535-9360

Mailing address

3817 W County Road 54G
Laporte, CO 80535-9360
Phone (970) 472-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110000613 CO Practitioner - Nurse Practitioner 2567832470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1107 S Lemay Ave
Suite 300
Fort Collins, CO 80524-3955

525 W Brown Rd
Mesa, AZ 85201-3202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC Current Accepting new patients
Fort Collins Women's Clinic, PC CurrentSince Oct 1, 2025 Accepting new patients
Little Poudre Family Clinic, LLC CurrentSince Aug 7, 2022 Accepting new patients
Little Poudre Family Clinic LLC CurrentSince Aug 7, 2022 Accepting new patients
Fort Collins Women's Clinic, P.C. CurrentSince Oct 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients

Locations

1107 S Lemay Ave
Ste 300
Fort Collins, CO 80524
Phone (970) 493-7442

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1230 14th St SW
Loveland, CO 80537
Phone (970) 619-3999

2500 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 493-7442

Interoperability endpoints

  • Direct secure messaging: elyse.diewaldfnpc.p1@direct.thewomensclinic.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1679200497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 W COUNTY ROAD 54G",
            "city": "LAPORTE",
            "state": "CO",
            "postal_code": "805359360",
            "telephone_number": "970-472-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 W COUNTY ROAD 54G",
            "city": "LAPORTE",
            "state": "CO",
            "postal_code": "805359360",
            "telephone_number": "970-472-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEWALD",
        "first_name": "ELYSE",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0997806-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laporte, CO

Sources for this page

Verify at the official NPI Registry.