Individual provider Active NPI

Diana L Kirby, FNP-BC

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1629188826
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN001606 Issued in NV
Practice address
9065 S Pecos Rd Ste 190
Henderson, NV 89074-6605
Phone
(702) 888-3148
Fax
(702) 888-3158
NPI assigned
Aug 30, 2006
Last updated
Mar 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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 APRN001606 NV Primary

Addresses

Primary practice location

9065 S Pecos Rd Ste 190
Henderson, NV 89074-6605

Mailing address

2370 Corporate Cir Ste 300
Henderson, NV 89074-7760
Phone (702) 910-3950

Other identifiers 1

IdentifierTypeStateIssuer
1629188826MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20140108001986 NV Practitioner - Nurse Practitioner 6002970316 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN001606NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bacchus PC CurrentSince Oct 1, 2018 Accepting new patients
Creighton University Past Accepting new patients
P3 Health Partners Professional Services PC Past Accepting new patients
Creighton University Past Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 239
Henderson, NV 89074
Phone (702) 844-4841

2370 Corporate Cir
Ste 300
Henderson, NV 89074
Phone (702) 910-3950

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1629188826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 CORPORATE CIR STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747760",
            "telephone_number": "702-910-3950",
            "fax_number": "702-778-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9065 S PECOS RD STE 190",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746605",
            "telephone_number": "702-888-3148",
            "fax_number": "702-888-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "DIANA",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629188826",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.