Individual provider Active NPI

Jacqueline Nichole Dipert, NP

  • Nurse Practitioner
  • La Jolla, CA
National Provider Identifier
1891020228
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP19200 Issued in CA
Practice address
9850 Genesee Ave
Ste 560
La Jolla, CA 92037-1224
Phone
(858) 455-6330
Fax
(858) 964-3135
NPI assigned
Oct 2, 2009
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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 NP19200 CA Primary

Addresses

Primary practice location

9850 Genesee Ave
Ste 560
La Jolla, CA 92037-1224

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 455-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100831000442 CA Practitioner - Nurse Practitioner 7517081383 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19200CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Mar 13, 2017 Accepting new patients
Scripps Health CurrentSince Mar 13, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

10666 N Torrey Pines Rd
#207W
La Jolla, CA 92037
Phone (858) 824-5824

10666 N Torrey Pines Rd
Fl 2
La Jolla, CA 92037
Phone (858) 554-8122

9850 Genesee Ave
Ste 560
La Jolla, CA 92037
Phone (858) 452-0306

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: jdipert10365@scrippshlth.medalliesdirect.net

Organizations & group practices 7

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1891020228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-455-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "STE 560",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-455-6330",
            "fax_number": "858-964-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPERT",
        "first_name": "JACQUELINE",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP19200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.