Active NPI
Diane Kay Demopulos, ARNP
- Nurse Practitioner
- Bellevue, WA
National Provider Identifier
1124320874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30002359
- Practice address
- 1810 116TH Ave NE
Suite D1
Bellevue, WA 98004-3058 - Phone
- (425) 455-2131
- NPI assigned
- Dec 1, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30002359 | WA | Primary |
Addresses
Primary practice location
1810 116TH Ave NE
Suite D1
Bellevue, WA 98004-3058
Mailing address
1810 116TH Ave NE
Suite D1
Bellevue, WA 98004-3058
Phone (425) 455-2131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9606245 | Medicaid | WA |
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
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291161600000",
"number": "1124320874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1810 116TH AVE NE",
"address_2": "SUITE D1",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043058",
"telephone_number": "425-455-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1810 116TH AVE NE",
"address_2": "SUITE D1",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043058",
"telephone_number": "425-455-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMOPULOS",
"first_name": "DIANE",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-01",
"last_updated": "2010-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30002359",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9606245",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.