Active NPI
Jacalyn Marie Diezman, CRNA
- Certified Registered Nurse Anesthetist
- Alliance, OH
National Provider Identifier
1699864421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- NA-00324
- Practice address
- 200 East State Street
Alliance, OH 44601 - Phone
- (330) 596-7227
- Fax
- (330) 596-7214
- NPI assigned
- Oct 12, 2006
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | NA-00324 | OH | Primary |
Addresses
Primary practice location
200 East State Street
Alliance, OH 44601
Mailing address
200 East State Street
Alliance, OH 44601
Phone (330) 596-7227
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430077988 | Other | MEDICARE RAILROAD | |
| 000000232285 | Other | ANTHEM | |
| 0847285 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NA-00324 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hudson Physicians Assoc Inc | Past | Accepting new patients | |
| Stark County Anesthesia, Inc. | 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 and National Provider Directory roles.
-
dba Barberton Anesthesia Care
- Anesthesiology Physician
- Barberton, OH
- NPI 1134175078
-
- Anesthesiology Physician
- Canton, OH
- NPI 1427009406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1699864421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 EAST STATE STREET",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "44601",
"telephone_number": "330-596-7227",
"fax_number": "330-596-7214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 EAST STATE STREET",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "44601",
"telephone_number": "330-596-7227",
"fax_number": "330-596-7214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEZMAN",
"first_name": "JACALYN",
"middle_name": "MARIE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "NA-00324",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "430077988",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000232285",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0847285",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alliance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.