Dianna E Bordelon

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2645 Lee St
Anchorage, AK 99504-3123

Phone

(907) 332-1350

Fax

(907) 332-1350

NPI assigned

Sep 3, 2009

Last updated

Aug 7, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1164655361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 LEE ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043123",
            "telephone_number": "907-332-1350",
            "fax_number": "907-332-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 LEE ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043123",
            "telephone_number": "907-332-1350",
            "fax_number": "907-332-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "DIANNA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CM0075",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.