NPIMap

Individual provider Active NPI

Dianna Elizabeth Wine, PA-C

  • Physician Assistant
  • Midlothian, VA
National Provider Identifier
1609155977
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008014 Issued in VA
Practice address
14163 Midlothian Tpke
Midlothian, VA 23113-6523
Phone
(804) 893-8702
Fax
(804) 767-5755
NPI assigned
Aug 4, 2011
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055676 PA
Physician Assistant 363A00000X 25MP00257500 NJ
Physician Assistant 363A00000X 0110008014 VA Primary

Addresses

Primary practice location

14163 Midlothian Tpke
Midlothian, VA 23113-6523

Mailing address

PO Box 631863
Cincinnati, OH 45263-1863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220328001259 VA Practitioner - Physician Assistant 1850516196 Reassigns benefits to 2 organizations
I20220331000279 DC Practitioner - Physician Assistant 1850516196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Urgent Care LLCGroup PAC ID 6709256142, 125 clinicians

Practice addresses (Care Compare)

10 N Nansemond St
Richmond, VA 23221-2768
Phone (804) 877-8327

11201 Nuckols Rd
Glen Allen, VA 23059-5502
Phone (804) 887-8322

14163 Midlothian Tpke
Midlothian, VA 23113-6523
Phone (804) 893-8702

1502 N Parham Rd
Richmond, VA 23229-4661
Phone (804) 877-8323

2230 W Broad St
Suite 101
Richmond, VA 23220-2037
Phone (804) 877-8329

4835 S Laburnum Ave
Richmond, VA 23231-2713
Phone (804) 877-8324

9851 Brook Rd
Glen Allen, VA 23059-4559
Phone (804) 893-8702

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00257500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Mar 15, 2022 Accepting new patients
American Current Care P.a. CurrentSince Mar 15, 2022 Accepting new patients
American Current Care PA CurrentSince Mar 15, 2022 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

4451 Parliament Pl
Ste G
Lanham, MD 20706
Phone (301) 459-9113

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

4301 W Broad St
Richmond, VA 23230
Phone (804) 358-0361

Interoperability endpoints

  • Direct secure messaging: dwine2521122@direct.bsmhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1609155977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631863",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14163 MIDLOTHIAN TPKE",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136523",
            "telephone_number": "804-893-8702",
            "fax_number": "804-767-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINE",
        "first_name": "DIANNA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055676",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00257500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.