Individual provider Active NPI

Robert Lewis Diem, PA-C

  • Physician Assistant
  • Fort Bragg, NC
National Provider Identifier
1962832139
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2817 Rock Merritt Avenue Stop a
Fort Bragg, NC 28310-3603
Phone
(352) 872-6336
NPI assigned
Nov 25, 2013
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2817 Rock Merritt Avenue Stop a
Fort Bragg, NC 28310-3603

Mailing address

2817 Rock Merrett Avenue Stop a
Fort Bragg, NC 28310-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230525002708 NC Practitioner - Physician Assistant 5395101869 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Medical Associates PastSince Jun 25, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rdiem114662@capefearvalley.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1962832139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRETT AVENUE STOP A",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE STOP A",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283103603",
            "telephone_number": "352-872-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEM",
        "first_name": "ROBERT",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-25",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.