Diane Van, DNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904388 Issued in MS

Practice address

205 Marion Ave
McComb, MS 39648-2705

Phone

(601) 684-9116

Fax

(601) 684-9126

NPI assigned

Sep 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Mississippi Regional Medical CenterGroup PAC ID 5193633907, 82 clinicians

McComb Og-GYN AssociatedGroup PAC ID 6103833959, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097
• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• McComb Og-GYN Associated

  • Specialist
  • McComb, MS
  • NPI 1952411217
  Medicare reassignment Care Compare group NPD
• Southwest Mississippi Regional Medical Center

  • Obstetrics & Gynecology Physician
  • McComb, MS
  • NPI 1982174488
  Medicare reassignment Care Compare group
• Vpa PC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1982224895
  Medicare reassignment
• Southwest Mississippi Regional Medical Center

  • Rural Health Clinic/Center
  • Summit, MS
  • NPI 1154008811
  NPD
• Southwest Mississippi Regional Medical Center

  • Urology Physician
  • McComb, MS
  • NPI 1649386061
  NPD
• Southwest Ms Regional Medical Center

  • Cardiovascular Disease Physician
  • Monticello, MS
  • NPI 1255422457
  NPD (past)

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

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation
• Southwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • McComb, MS
  • NPI 1407805971
  Care Compare affiliation

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1629685599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 25TH ST",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396485510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-684-9116",
            "fax_number": "601-684-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "DIANE",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "902568",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinencia J Turner, MSW
• Unlimited Companion Care LLC
• Sonya Carol Upton, RD, LD
• Aarti Vadalia, MD
• Van R Simmons DMD PA
• Tresea Vangilder
• Robert Vanuden, MD
• Frank Varino Jr.
• Callie Ann Venable, M.S. CCC-SLP
• Stephen Vennum III

• Family Nurse Practitioner in McComb, MS
• Providers in McComb, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.