Individual provider Active NPI

Diane L Taber, D.C.

  • Chiropractor
  • Bowie, MD
National Provider Identifier
1154322626
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01944 Issued in MD
Practice address
14300 Gallant Fox LN
Suite 201
Bowie, MD 20715-4003
Phone
(301) 352-4500
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S01944 MD Primary

Addresses

Primary practice location

14300 Gallant Fox LN
Suite 201
Bowie, MD 20715-4003

Mailing address

14300 Gallant Fox LN
Suite 201
Bowie, MD 20715-4003
Phone (301) 352-4500

Other identifiers 5

IdentifierTypeStateIssuer
LR25TAOtherMDCAREFIRST BCBS OF MD
287091OtherMDMAMSI ID
60608803OtherMDCAREFIRST MD REGION #
S2410001OtherDCCAREFIRST BC/BS
522247005OtherFEDERAL TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100701000520 DC Practitioner - Chiropractic 0042341273 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Taber Chiropractic, P.C. Chiropractor CurrentSince Jul 15, 2000 Accepting new patients

Locations

14300 Gallant Fox Ln
Ste 201
Bowie, MD 20715
Phone (301) 352-4500

4000 Mitchellville Rd
Ste A200
Bowie, MD 20716
Phone (301) 262-3311

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1154322626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN",
            "address_2": "SUITE 201",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154003",
            "telephone_number": "301-352-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN",
            "address_2": "SUITE 201",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154003",
            "telephone_number": "301-352-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABER",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "LR25TA",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI ID",
            "identifier": "287091",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD REGION #",
            "identifier": "60608803",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "S2410001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "522247005",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.