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GREGOR JACKSON DIERKS
NPI 1265173678
Student in an Organized Health Care Education/Training Program in Shreveport, LA

Active since April 07, 2022PECOS Enrolled
6051 ROMA DR APT 609, SHREVEPORT, LA 71105(971) 563-3919 Get Directions Write a Review

NPPES record last updated: April 7, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Gregor Jackson Dierks NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREGOR JACKSON DIERKS (NPI 1265173678) is an individual student in an organized health care education/training program in Shreveport, Louisiana and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265173678
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameGREGOR JACKSON DIERKS
Location Address6051 ROMA DR APT 609Shreveport, LA 71105-4671
Mailing Address6051 Roma Dr Apt 609Shreveport, LA 71105-4671 · (971) 563-3919
Phone(971) 563-3919
Sole ProprietorNo
Enumeration DateApril 7, 2022
NPPES CertifiedApril 7, 2022
✔ NPI 1265173678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
6051 ROMA DR APT 609, Shreveport, LA 71105
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gregor Jackson Dierks is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gregor Dierks's NPI number?

The NPI number for Gregor Dierks is 1265173678. It was assigned to this individual provider in the NPPES registry on April 7, 2022.

Where is Gregor Dierks located?

Gregor Dierks practices at 6051 Roma Dr Apt 609, Shreveport, LA 71105. The listed phone number is (971) 563-3919.

What is Gregor Dierks's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Gregor Dierks enrolled in Medicare?

Yes. Gregor Dierks is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gregor Dierks was last updated on April 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.