EDWARD JOHN DIEKHOFF (NPI# 1770530941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770530941 |
| Entity Type | Individual |
| Full Name | EDWARD JOHN DIEKHOFF |
| Credential | MD |
| Practice Address |
701 E County Line Rd Suite 201 Greenwood IN 46143 |
| Mailing Address |
6626 E 75th St Suite 500 Indianapolis IN 46250-2805 |
| Practice Telephone | 3178658000 |
| Practice Fax Number | 3178658012 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 01039037A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | CAQH ID | 10813894 | 01 |
| IN | RR MEDICARE PTAN | P01157057 | 01 |
| IN | MDWISE/PRO HEALTH ID | 000000001722 | 01 |
| IN | AETNA ELIGIBILITY ID | 4218208 | 01 |
| IN | ANTHEM ID | 000000351070 | 01 |
| IN | 200019310 | 05 | |
| IN | MEDICARE RAILROAD ID | P00171329 | 01 |
| Street Address |
701 E COUNTY LINE RD SUITE 201 |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679570956 | Andrew David Dick | Family Medicine | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1070 | 2005-07-01 |
| 1073044954 | Caitlin Elizabeth Luebcke | Nurse Practitioner | 701 E County Line Rd, #101, Greenwood, IN 46143-1072 | 2017-03-23 |
| 1043759319 | Hannah E Mason | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1070 | 2017-02-19 |
| 1750829230 | Altus Direct, LLC | Psychiatry & Neurology | 701 E County Line Rd, Suite 210, Greenwood, IN 46143-1072 | 2017-02-06 |
| 1205382801 | Gwendolyn Whitis | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2016-09-01 |
| 1215385174 | Erika Leigh Felt | Physician Assistant | 701 E County Line Rd, Suite 201, Greenwood, IN 46143-1072 | 2016-06-01 |
| 1124487145 | Rebecca E Pullyard | Registered Nurse | 701 E County Line Rd, Greenwood, IN 46143-1072 | 2016-02-18 |
| 1487013025 | Teena Nichole Mulholland | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2016-02-10 |
| 1821456765 | Juli Davette White | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2016-02-07 |
| 1083090021 | Kristen Mounce | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2015-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568912228 | Capel Surgical Clinic, LLC | Surgery | 406 E. Washington St., Greenwood, MS 38930 | 2016-10-06 |
| 1891189171 | Werner Heinrich Henning | Surgery | 1230 Colinbrook Cir, Greenwood, IN 46143-3608 | 2015-03-24 |
| 1457685570 | Self Medical Group | Surgery | 160 Academy Avenue, Greenwood, SC 29646-3808 | 2009-09-22 |
| 1982836847 | Self Medical Group | Surgery | 1325 Spring Street, Greenwood, SC 29646-3860 | 2009-08-11 |
| 1114161817 | Community Hospitals of Indiana Inc | Surgery | 533 E County Line Road, Suite 101, Greenwood, IN 46143-1074 | 2009-04-24 |
| 1558380477 | Douglas Edward Bowden | Surgery | 501 W Washington St, Greenwood, MS 38930-4237 | 2006-07-19 |
| 1629009956 | Stephen J O'neil | Surgery | 701 East County Line Road, Suite 201, Greenwood, IN 46143-1071 | 2006-07-05 |
| 1598794364 | Edward Joseph Rapp II | Surgery | 105 Vinecrest Ct, Ste 500, Greenwood, SC 29646-8031 | 2006-07-02 |
| 1114956919 | Premier Surgical Services, Pa | Surgery | 105 Vine Crest Ct, Ste 500, Greenwood, SC 29646-8031 | 2006-07-02 |
| 1578522934 | Raymond Girnys | Surgery | 302 8th St, Greenwood, MS 38930-4014 | 2006-03-22 |
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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.