Individual provider Active NPI

Diana Lyn Coleman, FNP

  • Family Nurse Practitioner
  • Rancho Cordova, CA
National Provider Identifier
1437354768
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
455969 Issued in CA
Practice address
2868 Prospect Park Dr.
Ste. 100
Rancho Cordova, CA 95670-6065
Phone
(916) 388-3532
Fax
(916) 388-3533
NPI assigned
Jun 18, 2007
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 455969 CA Primary

Addresses

Primary practice location

2868 Prospect Park Dr.
Ste. 100
Rancho Cordova, CA 95670-6065

Mailing address

6608 Mercy CT Ste B
Fair Oaks, CA 95628-3171
Phone (916) 241-9844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120111000071 CA Practitioner - Nurse Practitioner 4082881271 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Twain Health Care DistrictGroup PAC ID 7810327657, 17 clinicians

Practice addresses (Care Compare)

51 Wellness Way
Valley Springs, CA 95252-9736
Phone (209) 772-7070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
455969CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Feb 1, 2021 Accepting new patients
Mark Twain Health Care District CurrentSince Dec 1, 2021 Accepting new patients
Mark Twain Medical Center Past Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

51 Wellness Way
Valley Springs, CA 95252
Phone (209) 772-7070

Interoperability endpoints

  • Direct secure messaging: diana.coleman.1@19210.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1437354768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6608 MERCY CT STE B",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283171",
            "telephone_number": "916-241-9844",
            "fax_number": "916-241-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2868 PROSPECT PARK DR.",
            "address_2": "STE. 100",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706065",
            "telephone_number": "916-388-3532",
            "fax_number": "916-388-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "DIANA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "455969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.