Diana Primos, SOCIAL WORKER

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9460 Issued in SC

Practice address

6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102

Phone

(762) 408-4018

NPI assigned

Aug 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1609504638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMOS",
        "first_name": "DIANA",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Pandy
• Michael David Pointer, PA-C
• Michael Vincent Polis, REGISTERED DIETITIAN
• Robert Alan Powell, DO
• Jacques Prejean, MD
• John Franklin Rains, PA-C
• David Reynhout, PA
• Justin Richel
• Megan Renee Ripperger, MS, RD, CSSD, LD
• Stephanie Michelle Roche, P.T.

• Clinical Social Worker in Fort Moore, GA
• Providers in Fort Moore, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.