Active NPI
Kim L Diehl, MT
- Other Technician
- Harlem, MT
National Provider Identifier
1790080471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 146661
- Practice address
- 669 Agency Main St
Harlem, MT 59526-9455 - Phone
- (406) 353-3100
- Fax
- (406) 353-3108
- NPI assigned
- Jan 11, 2011
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 146661 | WI | Primary |
Addresses
Primary practice location
669 Agency Main St
Harlem, MT 59526-9455
Mailing address
669 Agency Main St
Harlem, MT 59526-9455
Phone (406) 353-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146661 | Other | WI | LICENSE |
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
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146661 | WI | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294704000000",
"number": "1790080471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "669 AGENCY MAIN ST",
"city": "HARLEM",
"state": "MT",
"postal_code": "595269455",
"telephone_number": "406-353-3100",
"fax_number": "406-353-3108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "669 AGENCY MAIN ST",
"city": "HARLEM",
"state": "MT",
"postal_code": "595269455",
"telephone_number": "406-353-3100",
"fax_number": "406-353-3108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEHL",
"first_name": "KIM",
"middle_name": "L",
"credential": "MT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-11",
"last_updated": "2011-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "WI",
"license": "146661",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "146661",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlem, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.