Diana Eastridge, NP-FAMILY

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CP002090 Issued in SD

Practice address

451 Junction Rd
Madison, WI 53717-2656

Phone

(608) 263-8915

Fax

(608) 265-5755

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1477589497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22741 SUNNYSIDE GULCH RD",
            "city": "SILVER CITY",
            "state": "SD",
            "postal_code": "577026059",
            "telephone_number": "608-512-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 JUNCTION RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172656",
            "telephone_number": "608-263-8915",
            "fax_number": "608-265-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTRIDGE",
        "first_name": "DIANA",
        "credential": "NP-FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "169519",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Weston Eastman, MSW
• Lauren Eastman
• Sarah Eastman, CF-SLP
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• Eastpark Dental LLC
• Eating Disorder Support Network
• Eating Disorder Support Network
• Kelsey James Eaton, DO
• Richard B Eaton, PA-C
• Steven Barry Eaton, D.D.S., F.A.G.D.

• Family Nurse Practitioner in Madison, WI
• Providers in Madison, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.