Dianna Waller Wadsworth, FNP

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

AP06883 Issued in LA

Practice address

1051 Gause Blvd
Suite 380
Slidell, LA 70458-2951

Phone

(985) 641-8191

Fax

(985) 641-9812

NPI assigned

Jul 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dianna Mary Waller Former name

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Van Meter Emergency Physicians Inc. Apmc

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1649410697
  Medicare reassignment NPD
• Clinton Harry Sharp III, M.D.

  • Family Medicine Physician
  • Slidell, LA
  • NPI 1508855198
  Medicare reassignment
• Slidell Family Medicine LLC

  • Family Medicine Physician
  • Slidell, LA
  • NPI 1821156878
  NPD

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1386990463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 CORPORATE SQUARE DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704583147",
            "telephone_number": "985-649-1152",
            "fax_number": "985-643-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 GAUSE BLVD",
            "address_2": "SUITE 380",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582951",
            "telephone_number": "985-641-8191",
            "fax_number": "985-641-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "DIANNA",
        "middle_name": "WALLER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "LA",
            "license": "AP06883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNA",
            "last_name": "WALLER",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Vu, PHARM D
• Bao Anh Jessica Cao Vu, PHARMD
• John F Vu, MD
• Martha Mary Vu, PHARMD
• Tram Anh Monique Cao Vu, DDS
• Blair Wagner
• Wagner's Transportation LLC
• Katey Fitzpatrick Wahden
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6588)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2665)

• Family Health Clinical Nurse Specialist in Slidell, LA
• Providers in Slidell, LA by specialty
• Family Health Clinical Nurse Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.