TERRENCE CHRISTOPHER DIEBOLD (CRNA) – Certified Registered Nurse Anesthetist, NPI 1174569602

TERRENCE CHRISTOPHER DIEBOLD (CRNA) is a healthcare provider. based in Jonesboro, Arkansas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. The NPI Number for TERRENCE CHRISTOPHER DIEBOLD (CRNA) is 1174569602

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
TERRENCE CHRISTOPHER DIEBOLD (CRNA)
NPI
1174569602
Phone
(870) 972-0281
Address
3120 PRESTWICK CIR
Enumeration Date
22 June 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9016826828
Graduation Year
2001 (25 years ago)
PAC ID
9032169198
Group Practice PAC ID
8921410341
Professional Enrollment ID
I20050126000621
Address ID
AR723352218FO1601XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:19State licenses:0Digital endpointsOther names

716 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AR

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Provider Addresses for TERRENCE CHRISTOPHER DIEBOLD (CRNA)

  • 3120, Prestwick Circle, Jonesboro, Craighead County, Arkansas, 72405, United States

    JONESBORO, AR 724018039

    Phone: (870) 972-0281

    Fax: (870) 972-8694

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050126000621ICertified Registered Nurse Anesthetist (Crna)ARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921410341View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)TN
Anesthesiology, Interventional Pain ManagementMO
Certified Registered Nurse Anesthetist (Crna)AR

Reviews

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Frequently asked questions

What identifier follows TERRENCE CHRISTOPHER DIEBOLD (CRNA) across health systems?
The NPI 1174569602 uniquely identifies TERRENCE CHRISTOPHER DIEBOLD (CRNA) in U.S. healthcare data.
Does the public listing show TERRENCE CHRISTOPHER DIEBOLD (CRNA) as active?
TERRENCE CHRISTOPHER DIEBOLD (CRNA)'s NPI record reflects an active status in NPPES.
What services align with TERRENCE CHRISTOPHER DIEBOLD (CRNA)'s listing?
TERRENCE CHRISTOPHER DIEBOLD (CRNA)'s public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Which community is linked to TERRENCE CHRISTOPHER DIEBOLD (CRNA)?
TERRENCE CHRISTOPHER DIEBOLD (CRNA) shows a connection to Jonesboro, Arkansas in registry-derived data.
Who maintains TERRENCE CHRISTOPHER DIEBOLD (CRNA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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