Carol M. Dietsch, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G034112 Issued in IA

Practice address

1441 W Central Park Ave
Davenport, IA 52804-1707

Phone

(563) 383-1900

NPI assigned

Feb 6, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Vera French Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bettendorf, IA
  • NPI 1568239978
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1821137548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041707",
            "telephone_number": "563-383-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041707",
            "telephone_number": "563-383-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETSCH",
        "first_name": "CAROL",
        "middle_name": "M.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G034112",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IA",
            "license": "034112",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420716337",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Diercks-Oetzel, D.C.
• Allen Lee Diercks, D.C.
• David W.R. Dierks, D.O.
• Dietrich Chiropractic PC
• L. Anthony Dietrich, DC
• James Stevan Digman, RPH
• Alexa Dillin, PA-C
• Ronald A Diotte, DC
• Eric J Dippel, M.D.
• Kelly Dirksen, OTR

• All providers in Davenport, IA
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.