Individual provider Active NPI

Renee Diekman

  • Registered Nurse
  • West Fargo, ND
National Provider Identifier
1891253282
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R19512 Issued in ND
Practice address
207 Main Ave W
West Fargo, ND 58078-1725
Phone
(701) 499-1022
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R19512NDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
West Fargo Public School District 6 Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R19512 ND Primary

Addresses

NPPES NPI Registry

Primary practice location

207 Main Ave W
West Fargo, ND 58078-1725

Mailing address

207 Main Ave W
West Fargo, ND 58078-1725
Phone (701) 499-1022

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 5, 2019.

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1891253282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 MAIN AVE W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580781725",
            "telephone_number": "701-499-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MAIN AVE W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580781725",
            "telephone_number": "701-499-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEKMAN",
        "first_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R19512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.