Tera Nicole Diewold, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002114 Issued in IA

Practice address

6000 University Ave
Ste 101
West Des Moines, IA 50266-8203

Phone

(515) 241-2600

Fax

(515) 241-2032

NPI assigned

Oct 6, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274
  Medicare reassignment NPD
• Iowa Physicians Clinic Medical Foundation

  • Rural Health Clinic/Center
  • Kingsley, IA
  • NPI 1659263523

  Physician Assistant

  NPD
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1801047170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1455",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503061455",
            "telephone_number": "515-961-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE",
            "address_2": "STE 101",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668203",
            "telephone_number": "515-241-2600",
            "fax_number": "515-241-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEWOLD",
        "first_name": "TERA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10492",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin M Diedrick, DPT
• Jordan Dielmann, ATC
• Stacia Nissen Dierks
• Deborah Emily Dietrich, D.D.S.
• Jeffrey Joseph Dietzenbach, M.D.
• Rebecca Anne Dillman, PA-C
• Megan Elizabeth Dillon, MS, CCC-SLP
• Sophia Dimonte
• Courtney Carole Dinsdale
• Lisa Louise Dittmer, LISW

• Physician Assistant in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.