Diane Klivington, DO, MS

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2094 Issued in AL

Practice address

104 Medical Dr
Dothan, AL 36303-6902

Phone

(850) 333-5113

NPI assigned

Feb 19, 2007

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Diane Laura Evans Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: devans348030@direct.centracare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Obstetrics & Gynecology of Dothan Inc

  dba Ladies First

  • Obstetrics & Gynecology Physician
  • Dothan, AL
  • NPI 1114021409
  Medicare reassignment NPD
• Mitchell Eye Center, PLLC

  • Clinic/Center
  • Selmer, TN
  • NPI 1235633199
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1407990740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MEDICAL DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036902",
            "telephone_number": "850-333-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MEDICAL DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036902",
            "telephone_number": "850-333-5113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Alcorn Dr",
            "address_2": "Magnolia Womens Center at Walnut",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388349321",
            "country_code": "US",
            "telephone_number": "662-223-4248",
            "fax_number": "662-223-6805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLIVINGTON",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "21472",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "1313",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "2094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04674024",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "EVANS",
            "middle_name": "LAURA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aristotle Onassis Kirkland, MSPT
• Jeffrey T Kirkland, CRNA
• Kara Kirkland
• Melissa Kirkland, PHARMD
• Robert Samuel Kline, PSY.D.
• KND Development 59 LLC
• Tera R. Knighton, C.P.N.P.
• Mayre Katherine Knox, CRNP
• Chandra Kumar Mallic Kodavanti, MD
• Joan Lee Kogelschatz, PHD

• Obstetrics & Gynecology Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Obstetrics & Gynecology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.