Individual provider Active NPI

Diana Cherise Rembert, CRNP

  • Nurse Practitioner
  • Grant, AL
National Provider Identifier
1467514331
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1076318 Issued in AL
Practice address
4500 Main St
Grant, AL 35747-8303
Phone
(256) 728-8600
Fax
(256) 728-8602
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1076318 AL Primary

Addresses

Primary practice location

4500 Main St
Grant, AL 35747-8303

Mailing address

PO Box 11407
Dept#0132
Birmingham, AL 35246-0132
Phone (256) 728-8600

Other identifiers 1

IdentifierTypeStateIssuer
528301710MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150513001860 AL Practitioner - Nurse Practitioner 9133449275 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1076318ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Family Medicine, LLC Current Accepting new patients
Marshall Medical Center North CurrentSince Mar 6, 2015 Accepting new patients

Locations

4500 Main St
Grant, AL 35747
Phone (256) 728-2600

Organizations & group practices 2

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": "1431388800000",
    "number": "1467514331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "address_2": "DEPT#0132",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460132",
            "telephone_number": "256-728-8600",
            "fax_number": "256-728-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MAIN ST",
            "city": "GRANT",
            "state": "AL",
            "postal_code": "357478303",
            "telephone_number": "256-728-8600",
            "fax_number": "256-728-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMBERT",
        "first_name": "DIANA",
        "middle_name": "CHERISE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1076318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528301710",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grant, AL

Sources for this page

Verify at the official NPI Registry.