Active NPI
Diane Tryon Latimer, PSY.D.
- Clinical Psychologist
- Powell, OH
National Provider Identifier
1114954674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2255
- Practice address
- 3843 Attucks Dr.
Suite B
Powell, OH 43065 - Phone
- (614) 553-7815
- Fax
- (336) 834-0149
- NPI assigned
- Jun 28, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2255 | NC | Primary |
Addresses
Primary practice location
3843 Attucks Dr.
Suite B
Powell, OH 43065
Mailing address
3843 Attucks Dr.
Suite B
Powell, OH 43065
Phone (614) 553-7815
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000011 | Medicaid | NC | |
| 0312L | Other | NC | BLUE CROSS BLUE SHIELD |
| 120080 | Other | NC | VALUEOPTIONS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2255 | NC | MD | Behavioral Analyst |
| 7173 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411084800000",
"number": "1114954674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3843 ATTUCKS DR.",
"address_2": "SUITE B",
"city": "POWELL",
"state": "OH",
"postal_code": "43065",
"telephone_number": "614-553-7815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3843 ATTUCKS DR.",
"address_2": "SUITE B",
"city": "POWELL",
"state": "OH",
"postal_code": "43065",
"telephone_number": "614-553-7815",
"fax_number": "336-834-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATIMER",
"first_name": "DIANE",
"middle_name": "TRYON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2014-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2255",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000011",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0312L",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "120080",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Powell, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.