Active NPI
Diane Elizabeth Dunston, M.D.
- Pediatric Adolescent Medicine Physician
- Athens, GA
National Provider Identifier
1629125646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 29631
- Practice address
- 675 College Ave
Athens, GA 30601-2635 - Phone
- (706) 546-5526
- Fax
- (706) 546-5687
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 29631 | GA | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 29631 | GA | Primary |
Addresses
Primary practice location
675 College Ave
Athens, GA 30601-2635
Mailing address
1120 Victoria Xing
Watkinsville, GA 30677-2131
Phone (706) 769-4947
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00342757A | Medicaid | GA |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29631 | GA | MD | Pediatric Adolescent Medicine Physician |
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.
-
- Pediatric Adolescent Medicine Physician
- Athens, GA
- NPI 1942723028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1629125646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 VICTORIA XING",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306772131",
"telephone_number": "706-769-4947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 COLLEGE AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306012635",
"telephone_number": "706-546-5526",
"fax_number": "706-546-5687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNSTON",
"first_name": "DIANE",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "29631",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "GA",
"license": "29631",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00342757A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.