Individual provider Active NPI

Diana Grace Stafford, MD

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1225322183
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
010127929 Issued in VA
Practice address
2021 Concert Dr Ste 202
Virginia Beach, VA 23456-8083
Phone
(757) 668-4980
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A150668 CA
Pediatrics Physician 208000000X 010127929 VA Primary
Pediatrics Physician 208000000X D0077878 MD

Addresses

Primary practice location

2021 Concert Dr Ste 202
Virginia Beach, VA 23456-8083

Mailing address

2021 Concert Dr Ste 202
Virginia Beach, VA 23456-8083
Phone (757) 668-4980

Other practice location 1

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (858) 499-2702

Other names 1

  • Diana Grace Newsom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A150668CAMDPediatrics Physician
D0077878MDMDPediatrics Physician
010127929VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

Interoperability endpoints

  • Direct secure messaging: dstafford177017@scrippshlth.medalliesdirect.net

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1225322183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 CONCERT DR STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234568083",
            "telephone_number": "757-668-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CONCERT DR STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234568083",
            "telephone_number": "757-668-4980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5525 Grossmont Center Dr",
            "address_purpose": "LOCATION",
            "city": "La Mesa",
            "state": "CA",
            "postal_code": "91942",
            "country_code": "US",
            "telephone_number": "858-499-2702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "DIANA",
        "middle_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A150668",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "010127929",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0077878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "NEWSOM",
            "middle_name": "GRACE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.