Diana Carmichael, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2017027617 Issued in GA

Practice address

1404 Southlake Plaza Dr
Morrow, GA 30260-1756

Phone

(770) 696-3960

Fax

(678) 550-9180

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Diana Lee Carmichael-Davis Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• DC Family Medical Clinic LLC

  • Family Medicine Physician
  • Morrow, GA
  • NPI 1114758083

  GA, Single Specialty

  Medicare reassignment NPD Authorized official
• Medical Office Force

  • Internal Medicine Physician
  • Athens, GA
  • NPI 1508378613

  GA, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1477054260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 BATTERSEA PL",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302482077",
            "telephone_number": "770-880-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 SOUTHLAKE PLAZA DR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302601756",
            "telephone_number": "770-696-3960",
            "fax_number": "678-550-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "DIANA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "2017027617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "CARMICHAEL-DAVIS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Evelyn Campbell-Bayaan, M.D.
• Alicia Canzius, RN
• Capitol Anesthesiology, PC
• Care First Private Home Care
• Angela Carmichael
• Mark Gerard Carmon, PHARM.D.
• Lashunda Carroll, CNA
• Centerwell Senior Primary Care Ga PC
• Cheng Chen, OD
• Peter Qiang Chen, O.D.

• All providers in Morrow, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.