Diana Lynn Herrick, CNM

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.006734 Issued in IL

Practice address

2016 Vadalabene Dr
Maryville, IL 62062-6901

Phone

(618) 288-2970

Fax

(618) 288-3572

NPI assigned

Sep 8, 2008

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dherrick6921@direct-ehr-ssmhc.com

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.

• SSM Health Care St Louis

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment Care Compare group NPD
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1932357472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E US HIGHWAY 40",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622942201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626901",
            "telephone_number": "618-288-2970",
            "fax_number": "618-288-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRICK",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209.006734041.253728",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.006734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Martin Henry, M.D.
• Adrian Lynn Henson
• Daniel Henson, RN
• Mallory Jean Henson, PA
• Kort Herman, DMD
• Dereck Hill, DMD
• Justin Bradley Hill, M.D.
• Thomas E Hill, MD
• Tara Suzanne Hilmes, NP
• Emily Lynne Hilton, PA

• Family Nurse Practitioner in Maryville, IL
• Providers in Maryville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.