Individual provider Active NPI

Diedra Thies

  • Family Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1790135481
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112018 Issued in NE
Practice address
1021 N 27TH St
Lincoln, NE 68503-1803
Phone
(402) 476-1455
Fax
(402) 476-1670
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 112018 NE Primary

Addresses

Primary practice location

1021 N 27TH St
Lincoln, NE 68503-1803

Mailing address

1021 N 27TH St
Lincoln, NE 68503-1803
Phone (402) 476-1455

Other identifiers 2

IdentifierTypeStateIssuer
10025024300MedicaidNE
10025024400MedicaidNE

Other names 1

  • Diedra Ann Artz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20160725000592 NE Practitioner - Nurse Practitioner 2062705338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Regional Health Services LLCGroup PAC ID 2567454564, 13 clinicians

Practice addresses (Care Compare)

2727 S 144TH St
Suite 280
Omaha, NE 68144-5252
Phone (402) 745-1145

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112018NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Regional Health Services LLC CurrentSince Jan 3, 2022 Accepting new patients
All Care Health Center CurrentSince Jan 17, 2022 Accepting new patients
Muc-Papillion LLC PastSince Nov 5, 2023 Accepting new patients

Locations

902 S 6th St
Rm A
Council Bluffs, IA 51501

902 S 6th St
Council Bluffs, IA 51501
Phone (712) 256-6583

818 Village Sq
Gretna, NE 68028
Phone (402) 332-4559

2727 S 144th St
Ste 280
Omaha, NE 68144
Phone (402) 745-1145

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4ed2ef3a-53e1-48ef-b364-a16c512d3488/

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1790135481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685031803",
            "telephone_number": "402-476-1455",
            "fax_number": "402-476-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685031803",
            "telephone_number": "402-476-1455",
            "fax_number": "402-476-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIES",
        "first_name": "DIEDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025024300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025024400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIEDRA",
            "last_name": "ARTZ",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.