Active NPI
Greg Dieleman, PHARM D
- Pharmacist
- Pella, IA
National Provider Identifier
1770247199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20995
- Practice address
- 802 Washington St
Pella, IA 50219-1525 - Phone
- (641) 628-1612
- Fax
- (641) 620-0021
- NPI assigned
- Oct 22, 2021
- Last updated
- Oct 22, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20995 | IA | Primary |
Addresses
Primary practice location
802 Washington St
Pella, IA 50219-1525
Mailing address
802 Washington St
Pella, IA 50219-1525
Phone (641) 628-1612
Other practice location 1
404 E 2nd Street
Prairie City, IA 50228
Phone (515) 994-2618
Other practice location 2
405 Monroe St
Pella, IA 50219-1189
Phone (641) 621-2444
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20995 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634860800000",
"number": "1770247199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 WASHINGTON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191525",
"telephone_number": "641-628-1612",
"fax_number": "641-620-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 WASHINGTON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502191525",
"telephone_number": "641-628-1612",
"fax_number": "641-620-0021"
}
],
"practiceLocations": [
{
"address_1": "404 E 2nd Street",
"address_purpose": "LOCATION",
"city": "Prairie City",
"state": "IA",
"postal_code": "50228",
"country_code": "US",
"telephone_number": "515-994-2618",
"fax_number": "515-994-3013",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "405 Monroe St",
"address_purpose": "LOCATION",
"city": "Pella",
"state": "IA",
"postal_code": "502191189",
"country_code": "US",
"telephone_number": "641-621-2444",
"fax_number": "641-628-2164",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIELEMAN",
"first_name": "GREG",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-22",
"last_updated": "2021-10-22",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pella, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.