Diane Simone McDermott, MEDICAL DOCTOR

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD25154 Issued in TN

Practice address

824 Wren Rd
Goodlettsville, TN 37072-2312

Phone

(615) 851-8959

Fax

(615) 851-5949

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• Diane Simone McDermott Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1104987262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 WREN RD",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722312",
            "telephone_number": "615-851-8959",
            "fax_number": "615-851-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 WREN RD",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722312",
            "telephone_number": "615-851-8959",
            "fax_number": "615-851-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "DIANE",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD25154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "205724681",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3094940",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "SSN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4147626",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6271922",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PRICING NO",
            "identifier": "3736131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01041710",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7078597",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSPRINGS",
            "identifier": "G20365",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "TN0102",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "MCDERMOTT",
            "middle_name": "SIMONE",
            "credential": "MEDICAL DOCTOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Misty Lee Matheney, CPRS
• Jeffrey W Mathews, D.D.S
• Yoshi Dawn Matthews
• Grace McCall, LMT
• Molly Ryan McCarthy, LMT
• Ronald Ian McDermott, MD
• Lori McKinney-Hagewood
• Jeremy Brooks McKinnon, LMSW
• Brandon Robert McNickle, PA-C
• Michael S Metzman, M.D.

• Family Medicine Physician in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.