Individual provider Active NPI

Diane Renee Kreitzer, MSN, RNC, CNP

  • Nurse Practitioner
  • Canton, OH
National Provider Identifier
1295767655
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP06936 Issued in OH
Practice address
5000 Higbee Ave NW
Canton, OH 44718-2522
Phone
(330) 493-0313
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP06936 OH Primary

Addresses

Primary practice location

5000 Higbee Ave NW
Canton, OH 44718-2522

Mailing address

5000 Higbee Ave NW
Canton, OH 44718-2522
Phone (330) 493-0313

Other identifiers 1

IdentifierTypeStateIssuer
6936MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060725000127 OH Practitioner - Nurse Practitioner 6901819689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP06936OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stark County Women'S Clinic Inc CurrentSince Sep 9, 2016 Accepting new patients

Locations

5000 Higbee Ave NW
Canton, OH 44718
Phone (330) 493-0313

4347 Portage St NW
Ste 102
North Canton, OH 44720

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1295767655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HIGBEE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182522",
            "telephone_number": "330-493-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HIGBEE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182522",
            "telephone_number": "330-493-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZER",
        "first_name": "DIANE",
        "middle_name": "RENEE",
        "credential": "MSN, RNC, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP06936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6936",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.