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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MACIE DIECKMAN
NPI 1336054055
Student in an Organized Health Care Education/Training Program in Jacksonville, FL

Active since August 17, 2026
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record added: August 17, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Macie Dieckman NPPES

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

MACIE DIECKMAN (NPI 1336054055) is an individual student in an organized health care education/training program in Jacksonville, Florida, licensed in North Carolina (L005888) and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1336054055
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMACIE DIECKMAN
Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865
Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (905) 953-2000
Phone(904) 953-2000
Sole ProprietorNo
Enumeration DateAugust 17, 2026
NPPES CertifiedAugust 17, 2026
✔ NPI 1336054055 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
License✔ Licensed in NC · L005888
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.
4500 SAN PABLO RD S, Jacksonville, FL 32224
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE L WALSH PA-C/MPH
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
DR. JAMI ANN ROTHE KINNUCAN M.D.
Internal Medicine (Gastroenterology)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
GLENN SHI MD
Orthopaedic Surgery
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MICHELLE TULANG MD
Internal Medicine
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
RICARDO PAGAN MD
Hospitalist
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
CRYSTAL LYNN CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
LAUREN E FREED CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MRS. MELINA VOLNER SOMMESE PA-C
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2594

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 Macie Dieckman's NPI number?

The NPI number for Macie Dieckman is 1336054055. It was assigned to this individual provider in the NPPES registry on August 17, 2026.

Where is Macie Dieckman located?

Macie Dieckman practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.

What is Macie Dieckman's specialty?

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

When was this NPI record last updated?

The NPPES record for Macie Dieckman was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.