Individual provider Active NPI

Andria Diamond, AGACNP, RN, RNFA

  • Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1124588603
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
GAA-NP000220 Issued in GA
Practice address
3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868
Phone
(706) 863-9595
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN0000029596 TN
Nurse Practitioner 363L00000X GAA-NP000220 GA Primary

Addresses

Primary practice location

3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868

Mailing address

3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868
Phone (706) 863-9595

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, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APN0000029596TNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1124588603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR STE 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR STE 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "ANDRIA",
        "credential": "AGACNP, RN, RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000029596",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP000220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.