Individual provider Active NPI

Julianne Dieckman, PA-C

  • Physician Assistant
  • Little Rock, AR
National Provider Identifier
1740026517
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
500 S University Ave Ste 101
Little Rock, AR 72205-5314
Phone
(501) 664-3914
NPI assigned
Jul 2, 2024
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

500 S University Ave Ste 101
Little Rock, AR 72205-5314

Mailing address

500 S University Ave Ste 101
Little Rock, AR 72205-5314
Phone (501) 664-3914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20241016003212 AR Practitioner - Physician Assistant 4587196456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians

Practice addresses (Care Compare)

500 S University Ave
Suite 101
Little Rock, AR 72205-5399
Phone (501) 664-3914

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pea Ridge Urgent Care Clinic Single Specialty CurrentSince Jul 31, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rapa.juliannedieckman@161924.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1740026517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055314",
            "telephone_number": "501-664-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055314",
            "telephone_number": "501-664-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKMAN",
        "first_name": "JULIANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.