Individual provider Active NPI

Diane Louise Danly

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Temple Terrace, FL
National Provider Identifier
1407918162
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
ME144294 Issued in FL
Practice address
12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904
Phone
(813) 871-8183
Fax
(813) 871-8184
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X ME144294 FL Primary

Addresses

Primary practice location

12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904

Mailing address

12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904
Phone (813) 871-8183

Other identifiers 1

IdentifierTypeStateIssuer
8117699MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200318000449 FL Practitioner - Hospice/Palliative CarePractitioner - Family Practice 6002886371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Pathways to Healthcare, LLC CurrentSince Aug 1, 2021 Accepting new patients
Major Hospital Past Accepting new patients
Our Hospice of South Central Indiana, Inc. Family Medicine PastSince Aug 24, 2017 Accepting new patients

Locations

1250 Grumman Pl
Ste B
Titusville, FL 32780
Phone (321) 269-4240

Organizations & group practices 3

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1407918162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 300W",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-871-8183",
            "fax_number": "813-871-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 300W",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-871-8183",
            "fax_number": "813-871-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANLY",
        "first_name": "DIANE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME144294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8117699",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.