Diane L Spiva, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN278076 Issued in GA

Practice address

10730 Medlock Bridge Rd Ste 110
Johns Creek, GA 30097-2638

Phone

(678) 344-8900

Fax

(678) 666-5201

NPI assigned

Nov 8, 2006

Last updated

Mar 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Advanced Gynecology PC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Watkinsville, GA
  • NPI 1093296824
  Medicare reassignment NPD
• Advanced Urology Institute of Georgia, LLC

  • Urology Physician
  • Snellville, GA
  • NPI 1073896510
  Medicare reassignment NPD
• Georgia Urology PA

  • Urology Physician
  • Riverdale, GA
  • NPI 1245250646
  Medicare reassignment NPD
• Urological Professional Services, LLC

  • Urology Physician
  • Atlanta, GA
  • NPI 1033521810
  Medicare reassignment NPD
• Advanced Gynecology PC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Atlanta, GA
  • NPI 1063095081
  NPD
• Advanced Urology Institute of Georgia, LLC

  • Urology Physician
  • Dallas, GA
  • NPI 1811846348
  NPD
• Georgia Urology PA

  • Urology Physician
  • Fayetteville, GA
  • NPI 1942426168
  NPD
• Georgia Urology, PA

  • Ambulatory Surgical Clinic/Center
  • Braselton, GA
  • NPI 1861222119
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1578632808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785686",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 MEDLOCK BRIDGE RD STE 110",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972638",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11660 Alpharetta Hwy",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764943",
            "country_code": "US",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIVA",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-117580",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-117580",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AL",
            "license": "1-117580",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55532",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN278076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN278076",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "RN278076",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "1-117580",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RNA LICENSE",
            "identifier": "55532",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP LICENSE",
            "identifier": "1-117580",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "1391784012",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole A Sparks, M.D.
• Special Transition Works , LLC
• Jay Erin Spector, DPM
• Speech Therapy Telepractice, LLC
• Diane C. Sperry
• St Mikels Behavioral Health Services LLC
• Monique Jennifer Stage, FNP-BC
• Courtney Eileen Starnes
• Stat Medical Care Inc
• Ashley Steele

• Family Nurse Practitioner in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; 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.