Individual provider Active NPI

Diana Jo Remenar, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1174046619
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07456 Issued in NC
Practice address
10420 Park Rd Ste 300
Charlotte, NC 28210-8502
Phone
(980) 237-4766
Fax
(980) 404-2274
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07456 NC Primary

Addresses

Primary practice location

10420 Park Rd Ste 300
Charlotte, NC 28210-8502

Mailing address

10225 Hickorywood Hill Ave
Huntersville, NC 28078-3430
Phone (704) 457-9292

Other practice location 1

10440 Park Rd Ste 300
Charlotte, NC 28210-8544
Phone (980) 237-4766

Other practice location 2

10225 Hickorywood Hill Ave
Huntersville, NC 28078-3430
Phone (704) 457-9292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016000088 NC Practitioner - Physician Assistant 5294000477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10420 Park Rd
Suite 300
Charlotte, NC 28210-8502
Phone (980) 237-4766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1174046619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 HICKORYWOOD HILL AVE",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783430",
            "telephone_number": "704-457-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108502",
            "telephone_number": "980-237-4766",
            "fax_number": "980-404-2274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10440 Park Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108544",
            "country_code": "US",
            "telephone_number": "980-237-4766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10225 Hickorywood Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280783430",
            "country_code": "US",
            "telephone_number": "704-457-9292",
            "fax_number": "704-919-5758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REMENAR",
        "first_name": "DIANA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.