Individual provider Active NPI

Diana Jane Ediger, NP

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1285884320
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-5758 Issued in CO
Practice address
2165 Hollow Brook Dr Ste 10a
Colorado Springs, CO 80918-1463
Phone
(719) 332-0070
Fax
(719) 434-3639
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 116123 CO
Nurse Practitioner 363L00000X NP-5758 CO Primary

Addresses

Primary practice location

2165 Hollow Brook Dr Ste 10a
Colorado Springs, CO 80918-1463

Mailing address

2165 Hollow Brook Dr Ste 10a
Colorado Springs, CO 80918-1463
Phone (719) 332-0070

Other identifiers 2

IdentifierTypeStateIssuer
5758OtherCOCOLORADO BOARD OF NURSING
116123OtherCOSTATE OF COLORADO

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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5758COMDProfessional Counselor
116123COMDRegistered Nurse
NP-5758COMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark C Meyer MD LLC Past Accepting new patients

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1285884320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 HOLLOW BROOK DR STE 10A",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181463",
            "telephone_number": "719-332-0070",
            "fax_number": "719-434-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 HOLLOW BROOK DR STE 10A",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181463",
            "telephone_number": "719-332-0070",
            "fax_number": "719-434-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDIGER",
        "first_name": "DIANA",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "116123",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "NP-5758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO BOARD OF NURSING",
            "identifier": "5758",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF COLORADO",
            "identifier": "116123",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.