COREY DIETZ CRNA
Complete NPI Record 1740737865
Nurse Anesthetist, Certified Registered in Danville, PA
Active since September 07, 2016Accepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Corey Dietz, CRNA (NPI 1740737865), an individual nurse anesthetist, certified registered provider in Danville, PA. All 31 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1740737865 Field 1/31
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/31
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: DIETZ Field 3/31
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: COREY Field 4/31
- The first name of the provider, if the provider is an individual.
- Provider Credential Text: CRNA Field 5/31
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 601 MEMORY LN Field 6/31
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: YORK Field 7/31
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: PA Field 8/31
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 174022231 Field 9/31
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 10/31
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 7178511405 Field 11/31
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 7178516969 Field 12/31
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 100 N ACADEMY AVE Field 13/31
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: DANVILLE Field 14/31
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: PA Field 15/31
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 178229800 Field 16/31
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/31
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 5702716621 Field 18/31
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 21/31
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 367500000X Field 22/31
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: RN608129 Field 23/31
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: PA Field 24/31
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 25/31
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 367500000X Field 26/31
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 5519 Field 27/31
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: NC Field 28/31
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 29/31
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 30/31
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 16
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
90 Medical Park Dr Ste 2000
Location 1/16Lewisburg, PA 17837-6343 · Phone (570) 524-2722 · Fax (570) 524-0362
55 Monument Rd
Location 2/16York, PA 17403-5023 · Phone (717) 812-6425 · Fax (717) 851-5250
4150 Barrett Blvd Ste 100
Location 3/16Ephrata, PA 17522-8979 · Phone (717) 859-5160 · Fax (717) 798-3935
501 E Main St
Location 4/16Waynesboro, PA 17268-2353 · Phone (717) 765-3425 · Fax (717) 765-3478
35 Erick Rd
Location 5/16Lancaster, PA 17601-3111 · Phone (717) 690-0811 · Fax (717) 283-4193
25 Monument Rd Ste 270
Location 6/16York, PA 17403-5073 · Phone (717) 741-8250 · Fax (717) 741-8289
112 N 7th St
Location 7/16Chambersburg, PA 17201-1720 · Phone (717) 267-7164 · Fax (717) 267-7414
835 5th Ave
Location 8/16Chambersburg, PA 17201-4220 · Phone (717) 217-4312 · Fax (717) 217-4314
236 West St
Location 9/16Gettysburg, PA 17325-2509 · Phone (717) 338-4500 · Fax (717) 334-6996
1227 Baltimore St
Location 10/16Hanover, PA 17331-4406 · Phone (717) 646-4204 · Fax (717) 646-4205
147 Gettys St
Location 11/16Gettysburg, PA 17325-2534 · Phone (717) 337-4168 · Fax (717) 337-4318
12 St Paul Dr Ste 100
Location 12/16Chambersburg, PA 17201-1035 · Phone (717) 217-6072 · Fax (717) 217-6952
252 S 4th St
Location 13/16Lebanon, PA 17042-6111 · Phone (717) 270-7500 · Fax (717) 228-1642
1 Hospital Dr
Location 14/16Lewisburg, PA 17837-9350 · Phone (570) 522-2000 · Fax (570) 768-3911
169 Martin Ave
Location 15/16Ephrata, PA 17522-1734 · Phone (717) 733-0311 · Fax (717) 721-5861
1001 S George St
Location 16/16York, PA 17403-3676 · Phone (717) 812-7687 · Fax (717) 851-5250
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