KATHLYN DIEFENDERFER (NPI# 1780606426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780606426 |
| Entity Type | Individual |
| Full Name | KATHLYN DIEFENDERFER |
| Credential | MD |
| Practice Address |
101 Professional Ln Enterprise AL 36330-2085 |
| Practice Telephone | 3343473404 |
| Practice Fax Number | 3343930613 |
| Mailing Telephone | 3347938087 |
| Mailing Fax Number | 3343930613 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 00023919 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009957070 | 05 | |
| AL | BLUE CROSS BLUE SHIELD | 51502734 | 01 |
| Street Address |
101 PROFESSIONAL LN |
| City | ENTERPRISE |
| State | AL |
| Zip Code | 36330-2085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528049863 | Maria Aurora Canlas Sucgang | Pediatrics | 101 Professional Ln, Enterprise, AL 36330-2085 | 2005-11-11 |
| 1609385293 | Whitni Michael Richard | Family Medicine | 101 Professional Ln, Enterprise, AL 36330-2085 | 2017-09-26 |
| 1285028928 | Jessica Jill Dunn | Nurse Practitioner | 101 Professional Ln, Enterprise, AL 36330-2085 | 2015-03-19 |
| 1922430602 | Carey Lauren Holloway Douglas | Nurse Practitioner | 101 Professional Ln, Enterprise, AL 36330-2085 | 2013-08-05 |
| 1134469620 | Amber Amuso Williams | Nurse Practitioner | 101 Professional Ln, Enterprise, AL 36330-2085 | 2013-02-21 |
| 1134487580 | Mary Leona Walch Pippin | Family Medicine | 101 Professional Ln, Enterprise, AL 36330-2085 | 2012-04-23 |
| 1043500465 | Julie Frances Hughes | Nurse Practitioner | 101 Professional Ln, Enterprise, AL 36330-2085 | 2011-04-19 |
| 1336448836 | Dermatology Associates of Bay County, P.a. | Dermatology | 101 Professional Ln, Enterprise, AL 36330-2085 | 2011-03-23 |
| 1538465323 | Dermatology Associates of Dothan, LLC | Specialist | 101 Professional Ln, Enterprise, AL 36330-2085 | 2011-01-27 |
| 1871893883 | Lucianne H Wiggins | Nurse Practitioner | 101 Professional Ln, Enterprise, AL 36330-2085 | 2010-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566860 | Julia Brooke Lowe | Pharmacist | 847 Boll Weivell Circle #112, Enterprise, AL 36330 | 2020-07-30 |
| 1134759640 | Benjamin Chase Marler | Student in an Organized Health Care Education/Training Program | 205 Somerset Pl, Enterprise, AL 36330 | 2020-01-23 |
| 1033694492 | Angel Melton | Counselor | 105 Searcy St, Enterprise, AL 36330 | 2018-10-01 |
| 1285180729 | Enterprise Urgent Care | Clinic/Center | 6582 Boll Weevil Circle, Enterprise, AL 36330 | 2016-08-25 |
| 1902204258 | Nikki Chen | Nurse Practitioner | 805 East Lee Street, Ste C, Enterprise, AL 36330 | 2014-12-17 |
| 1568795417 | Crystal Juanita Christian | Counselor | 1275 James Drive, Suite A Enterprise Behavioral Services, Enterprise, AL 36330 | 2009-09-10 |
| 1316173206 | Robert Noback | Preventive Medicine | 301 Dustoff Ave, Ft. Rucker, AL 36330 | 2009-06-05 |
| 1184892978 | Phillip Allen Fuller | Pulmonary Function Technologist | 130e.pondella Dr., Enterprise, AL 36330 | 2008-02-14 |
| 1720266778 | Richard Bauer | Emergency Medical Technician, Intermediate | Bld 301 Andrews Ave., Lyster Army Health Clinic, Ft Rucker, AL 36330 | 2008-02-01 |
| 1871646547 | Thomas Orson Patterson | Dentist | 306 South Edwards Street, Enterprise, AL 36330 | 2007-01-18 |
| Find all providers in zip 36330 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730297441 | John Andrew Kreisberg | Internal Medicine | 400 North Edwards Street, Enterprise, AL 36330-2510 | 2006-08-25 |
| 1285627109 | David Nelson Rhyne | Internal Medicine | 101 E Brunson St, Suite 200, Enterprise, AL 36330-2526 | 2005-08-25 |
| 1639491616 | Enterprise Clinic LLC | Internal Medicine | 805 E Lee St, Ste C, Enterprise, AL 36330-2093 | 2010-02-18 |
| 1801020029 | Jamie Bludsworth Jones | Internal Medicine | 101 Professional Ln, Enterprise, AL 36330-2085 | 2009-05-04 |
| 1184647992 | Gabruce Alan Young | Internal Medicine | 101 Professional Ln, Enterprise, AL 36330-2085 | 2006-07-25 |
| 1134178668 | William E Reynolds Jr. | Internal Medicine | 101 Professional Ln, Enterprise, AL 36330-2085 | 2006-05-10 |
| 1417907791 | Bruce R Williams | Internal Medicine | 805 E Lee St, Suite C, Enterprise, AL 36330-2368 | 2006-05-10 |
| 1063476836 | Professional Medical Associates PC | Internal Medicine | 101 E Brunson St, Suite 200, Enterprise, AL 36330 | 2006-04-17 |
| 1679567341 | Peter Anthony Veneziano | Internal Medicine | 101 E Brunson St, Suite 200, Enterprise, AL 36330-2526 | 2005-09-08 |
| 1972596849 | Gary G. Allen | Internal Medicine | 101 E Brunson St, Suite 200, Enterprise, AL 36330-2526 | 2005-08-25 |
| Find all providers in ENTERPRISE | ||||
| City | ENTERPRISE |
| Zip Code | 36330 |
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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.