Individual provider Active NPI

Diane Rackel, CFNP

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1295757664
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704139694 Issued in MI
Practice address
109 Bee St
Charleston, SC 29401-5703
Phone
(843) 577-5011
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704139694 MI Primary

Addresses

Primary practice location

109 Bee St
Charleston, SC 29401-5703

Mailing address

PO Box 304
Folly Beach, SC 29439-0304
Phone (989) 737-5744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20170713002227 SC Order and Referring Only - Nurse Practitioner 7315216900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704139694MIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1295757664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 304",
            "city": "FOLLY BEACH",
            "state": "SC",
            "postal_code": "294390304",
            "telephone_number": "989-737-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKEL",
        "first_name": "DIANE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704139694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.