Individual provider Active NPI

Jessica A Diefenbach, NP

  • Nurse Practitioner
  • Sparks, NV
National Provider Identifier
1861016735
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
879400 Issued in NV
Practice address
PO Box 50003
Sparks, NV 89435-0003
Phone
(214) 227-2457
Fax
(214) 764-0880
NPI assigned
Jun 5, 2020
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 879400 NV Primary

Addresses

Primary practice location

PO Box 50003
Sparks, NV 89435-0003

Mailing address

PO Box 2550
Rowlett, TX 75030-2550
Phone (214) 227-2457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NV2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20221215000365 AZ Practitioner - Nurse Practitioner 2567831498 Reassigns benefits to 1 organization
I20250606002850 NV Practitioner - Nurse Practitioner 2567831498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Surgical Assistant Services, LLCGroup PAC ID 8325580731, 2 clinicians

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Surgical Assistant Services, LLC Registered Nurse First Assistant CurrentSince Jun 2, 2025 Accepting new patients
Northern Arizona Surgical Assisting LLC Registered Nurse First Assistant CurrentSince Sep 26, 2023 Accepting new patients
LHCG Cxxxxiv, LLC Nurse Practitioner CurrentSince Jun 2, 2025 Accepting new patients

Locations

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

6490 S McCarran Blvd
Ste B13
Reno, NV 89509
Phone (775) 525-6700

9450 Double R Blvd
Ste 100
Reno, NV 89521
Phone (775) 525-6700

Interoperability endpoints

  • Direct secure messaging: jdiefenbach745491@direct.med.utah.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1861016735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2550",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750302550",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 50003",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894350003",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEFENBACH",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "879400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.