Individual provider Active NPI

Diane Buncelpn, LPN

  • Licensed Practical Nurse
  • Cartersville, GA
National Provider Identifier
1093931917
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN049647 Issued in GA
Practice address
218 Stonewall St
Cartersville, GA 30120-3628
Phone
(770) 386-1907
NPI assigned
Apr 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN049647 GA Primary

Addresses

Primary practice location

218 Stonewall St
Cartersville, GA 30120-3628

Mailing address

76 Lazy Water Dr SW
Euharlee, GA 30120-5934
Phone (770) 375-5069

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN049647GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cartersville Center, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093931917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 LAZY WATER DR SW",
            "city": "EUHARLEE",
            "state": "GA",
            "postal_code": "301205934",
            "telephone_number": "770-375-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 STONEWALL ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203628",
            "telephone_number": "770-386-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNCELPN",
        "first_name": "DIANE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN049647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.