NATHALIE K DIETHRICH (NPI# 1104374727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104374727 |
| Entity Type | Individual |
| Full Name | NATHALIE K DIETHRICH |
| Credential | PMHNP |
| Practice Address |
151 N Main St Decatur IL 62523-1206 |
| Practice Telephone | 2173626262 |
| Practice Fax Number | 2173626290 |
| Mailing Telephone | 2173626262 |
| Mailing Fax Number | 2173626290 |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2020-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
209.014716 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
151 N MAIN ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62523-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063029361 | Heritage Behavioral Health Cent Opt | Clinic/Center | 151 N Main St, Decatur, IL 62523-1206 | 2020-09-30 |
| 1881217206 | William Jihan | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-20 |
| 1053934471 | Jasmine M Kaylor | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-20 |
| 1891318218 | Andrea L Mccoy | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-20 |
| 1366065989 | Lindsay M Orlowski | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-19 |
| 1578186185 | Whitley B Hofer | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-19 |
| 1760003586 | Megan R Markwell | Registered Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-04 |
| 1316568132 | Erin Taylor | Registered Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-04 |
| 1902427982 | Latasha L Patton | Licensed Practical Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-01 |
| 1710508692 | Tayler J Dance | Licensed Practical Nurse | 151 N Main St, Decatur, IL 62523-1206 | 2020-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548763238 | Community Health Improvement Center | Clinic/Center | 1027 N Water, Decatur, IL 62523 | 2018-03-09 |
| 1093091597 | Leesa K Reed | Social Worker | 151 N. Main St., Heritage Behavioral Health, Decatur, IL 62523 | 2011-10-27 |
| 1407001357 | Pamela Sue Waterman | Counselor | 720 E. Wood St., Decatur, IL 62523 | 2008-11-19 |
| 1639231731 | Heritage Behavioral Health Center Inc. | Clinic/Center | 151 N Main Street, Decatur, IL 62523 | 2006-12-14 |
| 1669561080 | Diane S Pleasant | Counselor | 335 E Wood St Ste B, Decatur, IL 62523 | 2006-10-12 |
| 1376642470 | Gudrun Birgitta Armentrout | Marriage & Family Therapist | 247 West Prairie, Catholics Charities, Decatur, IL 62523 | 2006-09-22 |
| 1871117887 | Restore Wellness Counseling LLC | Social Worker | 106 North Main Street, Decatur, IL 62523 | 2020-06-04 |
| 1275004186 | Stephanie Maurer | Physician Assistant | 320 Central Ave, Decatur, IL 62523 | 2018-12-17 |
| 1669673620 | Decatur Public School Dist. #61 | Local Education Agency (LEA) | 101 W Cerro Gordo St, Decatur, IL 62523-1001 | 2007-05-29 |
| 1295246320 | Barbara A Nadler | Speech-Language Pathologist | 101 W Cerro Gordo St, Decatur, IL 62523-1001 | 2017-10-16 |
| Find all providers in zip 62523 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934988 | Tara Michelle Ridgeway | Nurse Practitioner | 2132 E Decatur St, Decatur, IL 62521-3148 | 2019-10-22 |
| 1245790914 | Faridy Maya Mombeleur | Nurse Practitioner | 2000 S Fm 51 Ste C, Decatur, TX 76234-3702 | 2019-03-20 |
| 1891204152 | Jasmine Keamber Mckinley | Nurse Practitioner | 1615 Kathy Ln Sw Ste 102, Decatur, AL 35603-1026 | 2017-09-29 |
| 1700305372 | Jessica Skarda | Nurse Practitioner | 1577-1631 Kathy Ln Sw, Decatur, AL 35603 | 2017-09-14 |
| 1306477138 | Obiageri Ohayagha | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030-1707 | 2020-01-30 |
| 1407405905 | Erica Y Taylor | Nurse Practitioner | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2019-09-06 |
| 1205309267 | Ashley M Garner | Nurse Practitioner | 320 E Central Ave, Decatur, IL 62521-4665 | 2019-01-02 |
| 1801379516 | Lauren Colegrove | Nurse Practitioner | 465 Winn Way Ste 221, Decatur, GA 30030-1723 | 2018-09-09 |
| 1619459542 | Okechukwu Nnaji | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030-1707 | 2018-09-06 |
| 1235634635 | Olubukola Funmi Olatoto | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030 | 2018-03-27 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.