Betsy Diaz, FNP-C
Individual provider Active NPI Nurse Practitioner · Shellman, GA
NPI 1104356302 · NPPES record last updated Sep 18, 2025
Key facts
- NPI
- 1104356302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN133959 (GA)
- Practice address
- 67 W Railroad St
Shellman, GA 39886-3100 - Phone
- (229) 679-2100
- NPI assigned
- Jun 20, 2017
- Reactivated
- Oct 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rural Urgent Care LLC
Practice addresses (Care Compare)
1026 S Eufaula Ave
Eufaula, AL 36027-2702
Phone (334) 689-4025
1245 Noah Dr
Jasper, GA 30143-8721
Phone (706) 253-1954
1730 Pat Thomas Pkwy
Quincy, FL 32351-8681
Phone (850) 662-0041
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in GA, AL, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171207001824 | GA | Practitioner - Nurse Practitioner | 9739446238 | Reassigns benefits to 1 organization |
| I20220322000080 | AL | Practitioner - Nurse Practitioner | 9739446238 | Reassigns benefits to 2 organizations |
| I20250929002191 | FL | Practitioner - Nurse Practitioner | 9739446238 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN133959 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shellman Medical LLC | Current |
Accepting new patients | |
| Rural Urgent Care LLC | Current |
Accepting new patients | |
| Rural Urgent Care LLC | Current | Accepting new patients | |
| Rural Urgent Care LLC | Current |
Accepting new patients | |
| Premier Cardiology Associates PLLC | Current |
Accepting new patients |
Locations
109 Medical Park Dr
Ste A
Andalusia, AL 36420
Phone (214) 701-7816
1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088
1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552
1093 Ross Clark Cir
Dothan, AL 36303
Phone (214) 701-7816
1275 James Dr
Ste A
Enterprise, AL 36330
Phone (334) 308-1940
1026 S Eufaula Ave
Eufaula, AL 36027
Phone (334) 687-5775
1730 Pat Thomas Pkwy
Quincy, FL 32351
Phone (850) 662-0041
1408 Tallahassee Hwy
Ste Z
Bainbridge, GA 39819
Phone (229) 400-9033
440 US Highway 84 E
Cairo, GA 39828
Phone (229) 307-2075
125 Benjamin H Hill Dr SW
Fitzgerald, GA 31750
Phone (229) 635-4004
162 E Jarman St
Hazlehurst, GA 31539
Phone (912) 209-0239
1245 Noah Dr
Jasper, GA 30143
Phone (706) 253-1954
67 W Railroad St
Shellman, GA 39886
Phone (229) 679-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11042326 | FL | |
| Nurse Practitioner | 363L00000X | RN133959 | GA | Yes |
| Family Nurse Practitioner | 363LF0000X | 1-144325 | AL |
Addresses
Primary practice location
67 W Railroad St
Shellman, GA 39886-3100
Mailing address
1500 1St Ave N
Unit 3
Birmingham, AL 35203-1866
Phone (205) 545-5088
Other providers in Shellman, GA
- Jessica Rose Faust
- Tiffany Harrell Garland
- Hospital Authority of Randolph County
- KJH Medical Services
- Georgie Edwards Langford
All providers in Shellman, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.