Individual provider Active NPI

Dianna Lynn Stukes, PA-C

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1306948195
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA59 Issued in DC
Practice address
50 Irving St NW
Washington, DC 20422-0001
Phone
(202) 745-8000
Fax
(202) 745-8500
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA59 DC Primary

Addresses

Primary practice location

50 Irving St NW
Washington, DC 20422-0001

Mailing address

2819 12TH St S
Arlington, VA 22204-4821
Phone (703) 979-0974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA59DCMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306948195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 12TH ST S",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222044821",
            "telephone_number": "703-979-0974",
            "fax_number": "703-979-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "204220001",
            "telephone_number": "202-745-8000",
            "fax_number": "202-745-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKES",
        "first_name": "DIANNA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA59",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.