Jennifer Dietrich, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172207 Issued in VA

Practice address

1504 Santa Rosa Rd RM 114
Henrico, VA 23229-5109

Phone

(804) 210-3103

Fax

(804) 210-3104

NPI assigned

Dec 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Dietrich Ayala Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA, MD3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdietrich@landmarkhealth-direct.org

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.

• Landmark Medical of Tennessee PC

  • General Practice Physician
  • Annapolis, MD
  • NPI 1922722172
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Virginia LLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1417076829

  DC

  Medicare reassignment
• WFS Home Care Enterprises, Inc. Dba at Home Harmony Pharmacy LTC

  • Long Term Care Pharmacy
  • Henrico, VA
  • NPI 1073256137
  NPD
• Landmark Medical of Tennessee PC

  • General Practice Physician
  • Westbrook, ME
  • NPI 1982310439
  NPD

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1821496720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ABBY RD",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229632085",
            "telephone_number": "434-589-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 SANTA ROSA RD RM 114",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232295109",
            "telephone_number": "804-210-3103",
            "fax_number": "804-210-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "AYALA",
            "middle_name": "DIETRICH",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diana Embler LCSW
• Tracey Dickens, LCSW
• Latanya D Dickerson-Tedder, DOULA
• Meredith Leigh Diehl, MD
• Maria Powell Dierdorf, LPC, LSATP
• Dimah LLC
• Discovery Counseling and Consulting LLC
• Divine Youth Counseling LLC
• Sarah Elizabeth Dix, LPC
• Ruchi Dixit, MPAS, PA-C

• Family Nurse Practitioner in Henrico, VA
• Providers in Henrico, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.