Diane Todd, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1139 Issued in KS

Practice address

57950 Leavenworth St
22D Medical Group
McConnell Afb, KS 67221-3506

Phone

(316) 759-5091

Fax

(316) 759-1304

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1225083090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57950 LEAVENWORTH ST",
            "address_2": "22D MEDICAL GROUP",
            "city": "MCCONNELL AFB",
            "state": "KS",
            "postal_code": "672213506",
            "telephone_number": "316-759-5091",
            "fax_number": "316-759-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57950 LEAVENWORTH ST",
            "address_2": "22D MEDICAL GROUP",
            "city": "MCCONNELL AFB",
            "state": "KS",
            "postal_code": "672213506",
            "telephone_number": "316-759-5091",
            "fax_number": "316-759-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "DIANE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Daniel Sigler, CADC
• Charissa Marie Slater, LMSW
• Maddison Smith
• Jonathan David Taylor, DMD
• Ryan J Thordal, D.O.
• Mark Truxillo, MD
• Jarron Robert Turnbull, NRP
• Jennifer Lynn Varney, DNP, FNP-BC
• Norma Alicia Villarreal, M.D.
• Frances R Waldren, LSCSW, LMAC

• All providers in McConnell Afb, KS
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.