Individual provider Active NPI

Diana L Seebock, GNP

  • Family Nurse Practitioner
  • Moraine, OH
National Provider Identifier
1619130077
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.06613-NP Issued in OH
Practice address
3033 Kettering Blvd Ste 100
Moraine, OH 45439-1948
Phone
(937) 293-2133
Fax
(937) 293-2161
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.06613-NP OH Primary

Addresses

Primary practice location

3033 Kettering Blvd Ste 100
Moraine, OH 45439-1948

Mailing address

3033 Kettering Blvd Ste 100
Moraine, OH 45439-1948
Phone (937) 293-2133

Other identifiers 3

IdentifierTypeStateIssuer
CS1431500185OtherOHCARE SOURCE
000000877722OtherOHANTHEM
0105748MedicaidOH

Other names 1

  • Diana Lynn Seebock Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040202000472 OH Practitioner - Nurse Practitioner 3476456781 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.06613-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Feb 15, 2016 Accepting new patients
Vpa PC CurrentSince Feb 15, 2016 Accepting new patients
Houston in Patient Physician Associates PLLC Past Accepting new patients
Neurosurgery Inc Past Accepting new patients
Geriatric Home Care Physicians PA Past Accepting new patients

Locations

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

3033 Kettering Blvd
Ste 100
Moraine, OH 45439
Phone (937) 293-2133

Organizations & group practices 7

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1619130077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 KETTERING BLVD STE 100",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391948",
            "telephone_number": "937-293-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 KETTERING BLVD STE 100",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391948",
            "telephone_number": "937-293-2133",
            "fax_number": "937-293-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEEBOCK",
        "first_name": "DIANA",
        "middle_name": "L",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.06613-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE",
            "identifier": "CS1431500185",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000877722",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105748",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "SEEBOCK",
            "middle_name": "LYNN",
            "credential": "RN, MSN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.