Individual provider Active NPI

Diane Mahin

  • Family Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1265017651
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R258589 Issued in MD
Practice address
15200 New Hampshire Ave
Silver Spring, MD 20905-5631
Phone
(301) 384-2166
NPI assigned
Mar 17, 2021
Last updated
Jun 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R258589 MD Primary
Pharmacist 183500000X 28551 MD
Pharmacist 183500000X PH24911 MA

Addresses

Primary practice location

15200 New Hampshire Ave
Silver Spring, MD 20905-5631

Mailing address

15200 New Hampshire Ave
Silver Spring, MD 20905-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250411001746 DC Practitioner - Nurse Practitioner 2163946179 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28551MDMDClinical Social Worker
PH24911MAMDPharmacist
R258589MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Muslim Community Center CurrentSince Jan 25, 2025 Accepting new patients
Walgreen Co PastSince Mar 1, 2021 Accepting new patients
Walgreen Co PastSince Mar 1, 2021 Accepting new patients

Locations

15200 New Hampshire Ave
Silver Spring, MD 20905
Phone (301) 384-2166

Organizations & group practices 3

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": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1265017651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 NEW HAMPSHIRE AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209055631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 NEW HAMPSHIRE AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209055631",
            "telephone_number": "301-384-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHIN",
        "first_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R258589",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "28551",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH24911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.