Individual provider Active NPI

Diane Carol Robinson, RN, FNP

  • Community Health Registered Nurse
  • Roseburg, OR
National Provider Identifier
1578980918
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
090003344 Issued in OR
Practice address
4285 Stella St
Roseburg, OR 97471-4771
Phone
(541) 868-6014
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 090003344 OR Primary
Wound Care Registered Nurse 163WW0000X 090003344 OR
Family Nurse Practitioner 363LF0000X 201809760NP OR

Addresses

Primary practice location

4285 Stella St
Roseburg, OR 97471-4771

Mailing address

4285 Stella St
Roseburg, OR 97471-4771
Phone (541) 868-6014

Other identifiers 1

IdentifierTypeStateIssuer
163WC1500XMedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20211116002675 OR Practitioner - Nurse Practitioner 5890783930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
090003344ORMDCommunity Health Registered Nurse
201809760NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1578980918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4285 STELLA ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974714771",
            "telephone_number": "541-868-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 STELLA ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974714771",
            "telephone_number": "541-868-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "DIANE",
        "middle_name": "CAROL",
        "credential": "RN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "090003344",
            "primary": true
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "OR",
            "license": "090003344",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201809760NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163WC1500X",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.