Haley M Dietzman

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8306 Issued in AZ

Practice address

2120 N Central Ave
Phoenix, AZ 85004

Phone

(602) 933-6100

Fax

(602) 933-2422

NPI assigned

Sep 26, 2012

Last updated

Jun 27, 2018By the provider in NPPES

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

Other names 1

• Haley A McGoldrick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Children's Hospital

  dba Phoenix Children's Medical Group

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  NPD
• Phoenix Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1962753343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85004",
            "telephone_number": "602-933-6100",
            "fax_number": "602-933-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZMAN",
        "first_name": "HALEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8306",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN 60220812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "MCGOLDRICK",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suzanne Diesel
• Timothy Ross Diestelkamp, MD
• Laura E Dietrich-Lake, FNP-C
• Aryanna Dietz
• Mark Dietzgen, NMD
• Ladon Dieu, RN
• Karen J Difrancesco, LCSW
• Digestive Health & Wellness, LLC (Dr. Liz Cruz Partners in Digestive Health)
• Digestive Health Center of Arizona
• Digestive Healthcare Associates, LLC

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.