Individual provider Active NPI

Diana Johns

  • Internal Medicine Physician
  • Coeur D Alene, ID
National Provider Identifier
1003838913
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6425 Issued in AK
Practice address
2248 W Rosebud LN
Coeur D Alene, ID 83814-7312
Phone
(907) 687-6248
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6425 AK Primary

Addresses

Primary practice location

2248 W Rosebud LN
Coeur D Alene, ID 83814-7312

Mailing address

2248 W Rosebud LN
Coeur D Alene, ID 83814-7312

Other identifiers 1

IdentifierTypeStateIssuer
MD0478MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8230NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nikos Inpatient Services Internal Medicine Past Accepting new patients
Idaho Falls Community Hospital LLC Past Accepting new patients
Eastern Idaho Medical Consultants Internal Medicine PastSince Nov 17, 1999 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1003838913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 W ROSEBUD LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838147312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 W ROSEBUD LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838147312",
            "telephone_number": "907-687-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "DIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "6425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0478",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.