Active NPI
Diana Joy Derussy, PHARM.D.
- Pharmacist
- Chattanooga, TN
National Provider Identifier
1235564329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 37211
- Practice address
- 1600 East 23Rd St
Chattanooga, TN 37404 - Phone
- (423) 629-4155
- Fax
- (423) 622-4558
- NPI assigned
- Sep 7, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 37211 | TN | Primary |
| Pharmacist | 183500000X | 022985 | GA |
Addresses
Primary practice location
1600 East 23Rd St
Chattanooga, TN 37404
Mailing address
1600 East 23Rd Street
Chattanooga, TN 37404
Phone (423) 629-4155
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37211 | Other | TN | TN PHARMACY LICENSE |
| 147401 | Other | TN | NABP |
Other names 1
- Miss Diana Joy Gabriel
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022985 | GA | MD | Pharmacist |
| 37211 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422835200000",
"number": "1235564329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 EAST 23RD STREET",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37404",
"telephone_number": "423-629-4155",
"fax_number": "423-622-4558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 EAST 23RD ST",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37404",
"telephone_number": "423-629-4155",
"fax_number": "423-622-4558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERUSSY",
"first_name": "DIANA",
"middle_name": "JOY",
"name_prefix": "Mrs.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-07",
"last_updated": "2015-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "37211",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "022985",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TN PHARMACY LICENSE",
"identifier": "37211",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "147401",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DIANA",
"last_name": "GABRIEL",
"middle_name": "JOY",
"prefix": "MISS",
"credential": "PHARM.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.