Individual provider Active NPI

Diane Lynne Raccio, APRN, ANP-BC

  • Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1053578377
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9340902 Issued in FL
Practice address
7005 Cortez Rd W
1St Floor
Bradenton, FL 34210-2509
Phone
(941) 750-0602
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 003797 CT
Nurse Practitioner 363L00000X ARNP9340902 FL Primary

Addresses

Primary practice location

7005 Cortez Rd W
1St Floor
Bradenton, FL 34210-2509

Mailing address

7005 Cortez Rd W
1St Floor
Bradenton, FL 34210-2509
Phone (941) 750-0602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121227000380 FL Practitioner - Nurse Practitioner 5092888388 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
003797CTMDProfessional Counselor
ARNP9340902FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Senior Healthcare Inc CurrentSince Jul 15, 2022 Accepting new patients

Locations

3914 E State Road 64
Bradenton, FL 34208
Phone (860) 250-4522

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16119/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1053578377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7005 CORTEZ RD W",
            "address_2": "1ST FLOOR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102509",
            "telephone_number": "941-750-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7005 CORTEZ RD W",
            "address_2": "1ST FLOOR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102509",
            "telephone_number": "941-750-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACCIO",
        "first_name": "DIANE",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "APRN, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "003797",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9340902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.