Individual provider Active NPI

Dianna J. Ohlman, NP-C

  • Family Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1952560260
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
124223 Issued in MO
Practice address
201 BJC Saint Peters Dr
Ste 200
Saint Peters, MO 63376-3385
Phone
(636) 916-9615
Fax
(636) 916-9850
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 124223 MO Primary

Addresses

Primary practice location

201 BJC Saint Peters Dr
Ste 200
Saint Peters, MO 63376-3385

Mailing address

201 BJC Saint Peters Dr Ste 200
Saint Peters, MO 63376-3386
Phone (636) 916-9615

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080929000016 MO Practitioner - Nurse Practitioner 0648347963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124223MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince May 1, 2012 Accepting new patients
Physician Groups LC CurrentSince May 1, 2012 Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

201 Bjc Saint Peters Dr
Ste 200
Saint Peters, MO 63376
Phone (636) 916-9615

5770 Mexico Rd
Ste D
Saint Peters, MO 63376
Phone (314) 842-2020

Organizations & group practices 2

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1952560260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BJC SAINT PETERS DR STE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763386",
            "telephone_number": "636-916-9615",
            "fax_number": "636-916-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BJC SAINT PETERS DR",
            "address_2": "STE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763385",
            "telephone_number": "636-916-9615",
            "fax_number": "636-916-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHLMAN",
        "first_name": "DIANNA",
        "middle_name": "J.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "124223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "201 Bjc Saint Peters Dr",
            "address_2": "STE 200",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633763385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.