Individual provider Active NPI

Diana Kristine Falise, APRN

  • Family Nurse Practitioner
  • Green Cove Springs, FL
National Provider Identifier
1083301998
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11023934 Issued in FL
Practice address
1305 N Orange Ave
Green Cove Springs, FL 32043-2547
Phone
(904) 284-5904
Fax
(904) 284-5905
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 11023933 FL
Family Nurse Practitioner 363LF0000X 10046724 OR
Family Nurse Practitioner 363LF0000X 11023934 FL Primary

Addresses

Primary practice location

1305 N Orange Ave
Green Cove Springs, FL 32043-2547

Mailing address

1302 River St
Palatka, FL 32177-5042
Phone (386) 328-0108

Other practice location 1

3400 Cooperative Way
Lebanon, OR 97355-4063
Phone (541) 666-3305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231219003870 FL Practitioner - Nurse Practitioner 0244680031 Reassigns benefits to 1 organization
I20250904002365 OR Practitioner - Nurse Practitioner 0244680031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

3400 Cooperative Way
Lebanon, OR 97355-3984
Phone (541) 640-7625

Hospital & facility affiliations

  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11023933FLMDGeneral Practice Registered Nurse
11023934FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Care, Inc. CurrentSince Nov 11, 2023 Accepting new patients
Rural Health Care Incorporated CurrentSince Nov 11, 2023 Accepting new patients
Rural Health Care Incorporated Current Accepting new patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Oct 6, 2025 Accepting new patients
Icco, LLC CurrentSince Oct 6, 2025 Accepting new patients

Locations

100 Commercial Dr
Keystone Hgts, FL 32656
Phone (352) 473-6595

1302 River St
Palatka, FL 32177
Phone (386) 328-0108

600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

355 W 3rd Ave
Junction City, OR 97448
Phone (541) 998-2468

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

Interoperability endpoints

  • Direct secure messaging: diana.falise.p1@direct.azahealth.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1083301998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 RIVER ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321775042",
            "telephone_number": "386-328-0108",
            "fax_number": "386-325-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N ORANGE AVE",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320432547",
            "telephone_number": "904-284-5904",
            "fax_number": "904-284-5905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Cooperative Way",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973554063",
            "country_code": "US",
            "telephone_number": "541-666-3305",
            "fax_number": "541-666-3306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FALISE",
        "first_name": "DIANA",
        "middle_name": "KRISTINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "11023933",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10046724",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11023934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Cove Springs, FL

Sources for this page

Verify at the official NPI Registry.