Active NPI
Diane Lynn Dunniway, NPP
- Obstetrics & Gynecology Nurse Practitioner
- Stamford, CT
National Provider Identifier
1104986330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- 209004498
- Practice address
- 1180 Newfield Ave
Stamford, CT 06905-1409 - Phone
- (314) 888-5233
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 209004498 | IL | Primary |
Addresses
Primary practice location
1180 Newfield Ave
Stamford, CT 06905-1409
Mailing address
1180 Newfield Ave
Stamford, CT 06905-1409
Phone (314) 888-5233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041207195 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
380 Castle Wynd Dr
Loves Park, IL 61111-8935
Phone (314) 888-5233
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
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": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1104986330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 NEWFIELD AVE",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069051409",
"telephone_number": "314-888-5233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 NEWFIELD AVE",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069051409",
"telephone_number": "314-888-5233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNNIWAY",
"first_name": "DIANE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "NPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "IL",
"license": "209004498",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041207195",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.