Individual provider Active NPI

Fred Ferris Diegmann, MD

  • Obstetrics & Gynecology Physician
  • Fairhope, AL
National Provider Identifier
1720046204
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
000001748 Issued in AL
Practice address
150 S Ingleside St
Suite2
Fairhope, AL 36532-1803
Phone
(251) 990-6550
Fax
(251) 990-6552
NPI assigned
May 3, 2006
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 000001748 AL Primary

Addresses

Primary practice location

150 S Ingleside St
Suite2
Fairhope, AL 36532-1803

Mailing address

150 S Ingleside St
Suite2
Fairhope, AL 36532-1803
Phone (251) 990-6550

Other identifiers 1

IdentifierTypeStateIssuer
009940422MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031112000798 AL Practitioner - Obstetrics/Gynecology 2860306073 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
000001748ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diegmann and Henderson OBGYN PC Obstetrics & Gynecology CurrentSince Nov 1, 2006 Accepting new patients
Fairhope Internal Medicine PC PastSince Mar 19, 2018 Accepting new patients
Bay Eyes Cataract and Laser Center, Inc. Past Accepting new patients

Locations

150 S Ingleside St
#2
Fairhope, AL 36532
Phone (251) 990-6550

2 Medical Park Dr
Fairhope, AL 36532
Phone (251) 990-6550

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1720046204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S INGLESIDE ST",
            "address_2": "SUITE2",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321803",
            "telephone_number": "251-990-6550",
            "fax_number": "251-990-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S INGLESIDE ST",
            "address_2": "SUITE2",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321803",
            "telephone_number": "251-990-6550",
            "fax_number": "251-990-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEGMANN",
        "first_name": "FRED",
        "middle_name": "FERRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "000001748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009940422",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.