Active NPI
Diana P Sands, NP
- Neonatal Nurse Practitioner
- Portland, ME
National Provider Identifier
1255506176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- CNP191012
- Practice address
- 22 Bramhall St
Portland, ME 04102 - Phone
- (207) 662-2273
- Fax
- (207) 662-6324
- NPI assigned
- Apr 23, 2008
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Intensive Care Registered Nurse | 163WN0002X | 170526 | AZ | |
| Nurse Practitioner | 363L00000X | COANP03048 | OH | |
| Neonatal Nurse Practitioner | 363LN0000X | 170526 | AZ | |
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | NCCSAN104280215 | OH | |
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | AP4462 | AZ | |
| Neonatal Nurse Practitioner | 363LN0000X | CNP191012 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CNP191012 | Other | ME | LICENSE |
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COANP03048 | OH | MD | Nurse Practitioner |
| 170526 | AZ | MD | Neonatal Nurse Practitioner |
| CNP191012 | ME | MD | Neonatal Nurse Practitioner |
| AP4462 | AZ | MD | Critical Care Neonatal Nurse Practitioner |
| NCCSAN104280215 | OH | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert South, Inc. | Current | Accepting new patients | |
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Current | Accepting new patients | |
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Current | Accepting new patients | |
| Neonatology Associates, LTD | Neonatal | Past | Accepting new patients |
Locations
2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298
4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187
6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300
9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000
Organizations & group practices 4
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.
-
- Public Health or Welfare Agency
- Phoenix, AZ
- NPI 1083643738
-
- Public Health or Welfare Agency
- Maricopa, AZ
- NPI 1538043443
-
- Family Medicine Physician
- Kenosha, WI
- NPI 1558305284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1255506176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2273",
"fax_number": "207-662-6324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04102",
"telephone_number": "207-662-2273",
"fax_number": "207-662-6324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDS",
"first_name": "DIANA",
"middle_name": "P",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "AZ",
"license": "170526",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COANP03048",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "AZ",
"license": "170526",
"primary": false
},
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "OH",
"license": "NCCSAN104280215",
"primary": false
},
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "AZ",
"license": "AP4462",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "ME",
"license": "CNP191012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "CNP191012",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.