Active NPI
Jean Paula Diemer, MD
- Pediatrics Physician
- Cape Girardeau, MO
National Provider Identifier
1942556089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R3P88
- Practice address
- 3250 Gordonville Rd Ste 301
Cape Girardeau, MO 63703-5095 - Phone
- (573) 334-9641
- Fax
- (573) 331-4130
- NPI assigned
- Jul 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R3P88 | MO | Primary |
Addresses
Primary practice location
3250 Gordonville Rd Ste 301
Cape Girardeau, MO 63703-5095
Mailing address
PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 868036 | Other | MO | ANTHEM BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- jdiemer10684@surescripts.sfmc.net
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1942556089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 801143",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641801143",
"telephone_number": "573-331-5583",
"fax_number": "573-331-5079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 GORDONVILLE RD STE 301",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035095",
"telephone_number": "573-334-9641",
"fax_number": "573-331-4130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEMER",
"first_name": "JEAN",
"middle_name": "PAULA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-26",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R3P88",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "868036",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.