Diana Lynn Johnson, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

0260019756 Issued in VT

Practice address

278 VT Route 149
West Pawlet, VT 05775-9798

Phone

(802) 645-0580

NPI assigned

Jun 24, 2018

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 5, 2020.

{
    "created_epoch": "1529798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1497240378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 MILL POND RD",
            "city": "WELLS",
            "state": "VT",
            "postal_code": "057749911",
            "telephone_number": "802-645-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 VT ROUTE 149",
            "city": "WEST PAWLET",
            "state": "VT",
            "postal_code": "057759798",
            "telephone_number": "802-645-0580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2987 Vt Route 22A",
            "address_purpose": "LOCATION",
            "city": "Shoreham",
            "state": "VT",
            "postal_code": "057709728",
            "country_code": "US",
            "telephone_number": "802-897-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Grove St",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "VT",
            "postal_code": "057339062",
            "country_code": "US",
            "telephone_number": "802-247-6305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Stratton Rd",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014621",
            "country_code": "US",
            "telephone_number": "802-773-3386",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 General Wing Rd",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014681",
            "country_code": "US",
            "telephone_number": "802-773-9131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Route 30 N",
            "address_purpose": "LOCATION",
            "city": "Bomoseen",
            "state": "VT",
            "postal_code": "057329647",
            "country_code": "US",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-24",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "VT",
            "license": "0260019756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in West Pawlet, VT
• Diabetes Educator Registered Nurse in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.