Individual provider Active NPI

Jean Paula Diemer, MD

  • Pediatrics Physician
  • Cape Girardeau, MO
National Provider Identifier
1942556089
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R3P88 Issued in MO
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

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
868036OtherMOANTHEM 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

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.