Individual provider Active NPI

Dianne Louise Bunner, CRNP

  • Neonatal Nurse Practitioner
  • Foley, AL
National Provider Identifier
1215204292
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
1-088480 Issued in AL
Practice address
1613 N McKenzie St
Foley, AL 36535-2247
Phone
(251) 949-3710
Fax
(251) 949-3715
NPI assigned
Nov 19, 2011
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1-088480 AL Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X COA.12665-NP OH

Addresses

Primary practice location

1613 N McKenzie St
Foley, AL 36535-2247

Mailing address

1613 N McKenzie St
Foley, AL 36535-2247

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106
Phone (216) 844-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200518001310 AL Practitioner - Nurse Practitioner 8820227465 Reassigns benefits to 2 organizations
I20221223000039 MS Practitioner - Nurse Practitioner 8820227465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-088480ALMDNeonatal Nurse Practitioner
COA.12665-NPOHMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 11, 2022 Accepting new patients
Foley Clinic Corp CurrentSince Jul 28, 2023 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Apr 1, 2020 Accepting new patients
Foley Clinic Corp CurrentSince Jul 28, 2023 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Apr 1, 2020 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Aug 11, 2022 Accepting new patients

Locations

161 W Peachtree Ave
Foley, AL 36535
Phone (251) 943-5511

1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

4566 S Eason Blvd
Tupelo, MS 38801
Phone (662) 377-4962

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: dbunner250586@direct.ccf.org
  • FHIR API: https://api.platform.athenahealth.com/1599/brand/1/csg/341/fhir/r4

Organizations & group practices 8

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": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1215204292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352247",
            "telephone_number": "251-949-3710",
            "fax_number": "251-949-3715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "44106",
            "country_code": "US",
            "telephone_number": "216-844-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNNER",
        "first_name": "DIANNE",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-19",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AL",
            "license": "1-088480",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "COA.12665-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.