LEE A DIEDERICK (NPI# 1699792556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699792556 |
| Entity Type | Individual |
| Full Name | LEE A DIEDERICK |
| Credential | CRNA |
| Practice Address |
737 Broadway Fargo ND 58122-0001 |
| Practice Telephone | 7012346258 |
| Practice Fax Number | 7012342345 |
| Mailing Telephone | 7012346258 |
| Mailing Fax Number | 7012342345 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2008-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | R15726 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
737 BROADWAY |
| City | FARGO |
| State | ND |
| Zip Code | 58122-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437103959 | Robin J Sickels | Dietitian, Registered | 737 Broadway, Fargo, ND 58122-0001 | 2006-05-20 |
| 1679883680 | Summer Schauer | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122-0001 | 2010-10-13 |
| 1588974596 | Melissa Vanmatre | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122-0001 | 2010-10-13 |
| 1164652640 | Sanford Clinic North | Clinical Medical Laboratory | 737 Broadway, Fargo, ND 58122-0045 | 2009-07-20 |
| 1710138375 | Kent C Moser | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122-0001 | 2008-10-01 |
| 1023268711 | Katie C Busker | Nurse Anesthetist, Certified Registered | 737 Broadway, Fargo, ND 58122 | 2008-09-30 |
| 1770731473 | Andrea B Peterson | Nurse Practitioner | 737 Broadway, Fargo, ND 58122-0001 | 2008-09-05 |
| 1801091384 | Vijay Korimilli | Internal Medicine | 737 Broadway, Fargo, ND 58122-0001 | 2007-06-15 |
| 1437362571 | Heidi J Lako-adamson | Emergency Medicine | 737 Broadway, Fargo, ND 58122-0001 | 2007-05-07 |
| 1164567970 | Kristen M Liebl | Dietary Manager | 737 Broadway, Fargo, ND 58122-0001 | 2007-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184142747 | Kayla Estepp | Internal Medicine | 737 Broadway North, Fargo, ND 58122 | 2017-09-05 |
| 1376091793 | Paul Mckay | Physical Therapist | 801 Broadway N., Fargo, ND 58122 | 2016-09-14 |
| 1801290150 | Mark Noah | Physical Therapist | 1720 South University, Fargo, ND 58122 | 2014-10-15 |
| 1245633486 | Diana Palm | Physical Therapist | 1720 University Drive South, Fargo, ND 58122 | 2014-10-02 |
| 1447696406 | Mohamad Imam | Internal Medicine | 801 Broadway North, Fargo, ND 58122 | 2013-05-17 |
| 1457615155 | Chantee Seung Gruenhagen | Nurse Practitioner | 737 North Broadway, Sanford Urology Clinic, Fargo, ND 58122 | 2012-06-27 |
| 1457594079 | Manisha Balhara | Specialist | 2400 32nd Avenue S, Fargo, ND 58122 | 2009-04-13 |
| 1578536728 | Shelby A Terstriep | Internal Medicine | 820 4 Street North, Fargo, NC 58122 | 2006-02-08 |
| 1295229946 | Christopher Hinh | Student in an Organized Health Care Education/Training Program | 801 Broadway North, Fargo, ND 58122 | 2018-06-17 |
| 1558854539 | Suchita Kotnala | Family Medicine | 737 Broadway North, Fargo, ND 58122 | 2018-06-13 |
| Find all providers in zip 58122 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548659808 | Red River Locums LLP | Nurse Anesthetist, Certified Registered | 1507 University Dr S, Fargo, ND 58103-4169 | 2015-01-09 |
| 1336440924 | Megan Maria Dallman | Nurse Anesthetist, Certified Registered | Sanford Health Anesthesia Department, 737 Broadway, Fargo, ND 58122-0001 | 2010-11-12 |
| 1508895954 | Ronald Beare | Nurse Anesthetist, Certified Registered | 2669 Meadow Creek Circle, Fargo, ND 58104-7112 | 2006-06-30 |
| 1982654646 | Todd Arlen Gross | Nurse Anesthetist, Certified Registered | 2301 25th St S Ste K, Fargo, ND 58103-6104 | 2006-05-11 |
| 1669098976 | Nathaniel James Piersol | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-23 |
| 1134743941 | Joshua Levee | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-06-08 |
| 1942824388 | Amanda Paulson | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-06-02 |
| 1689298390 | Emily Marshelle Wolters | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-05-29 |
| 1194350132 | Courtney Nicole Huston | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-03-10 |
| 1386276863 | Corey David Bos | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-02-12 |
| Find all providers in FARGO | ||||
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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.