Individual provider Active NPI

Dianne L Church, CRNP

  • Adult Health Nurse Practitioner
  • Erie, PA
National Provider Identifier
1366105488
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP021459 Issued in PA
Practice address
100 Peach St Ste 200
Erie, PA 16507-1423
Phone
(814) 877-7733
NPI assigned
Oct 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP021459 PA Primary

Addresses

Primary practice location

100 Peach St Ste 200
Erie, PA 16507-1423

Mailing address

3913 Wagner Ave
Erie, PA 16510-3935
Phone (814) 403-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20211109001187 PA Practitioner - Nurse Practitioner 9931598109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

300 State St
Erie, PA 16507-1427
Phone (814) 877-6111

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

  • Upmc Hamot Hospital, Erie, PA, CCN 390063

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP021459PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Oct 24, 2021 Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

100 Peach St
Ste 200
Erie, PA 16507
Phone (814) 456-7733

300 State St
Ste 401
Erie, PA 16507
Phone (814) 877-4577

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

Interoperability endpoints

  • Direct secure messaging: dianne.l.church@upmcdirect.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1366105488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 WAGNER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165103935",
            "telephone_number": "814-403-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEACH ST STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-877-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "DIANNE",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP021459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.