Individual provider Active NPI

Diane L McIntire, MD

  • Pediatrics Physician
  • Lubbock, TX
National Provider Identifier
1689698409
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J8668 Issued in TX
Practice address
5807 63Rd St
Suite 200
Lubbock, TX 79424-2740
Phone
(806) 771-7286
Fax
(806) 771-7289
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J8668 TX Primary

Addresses

Primary practice location

5807 63Rd St
Suite 200
Lubbock, TX 79424-2740

Mailing address

5807 63Rd St
Suite 200
Lubbock, TX 79424-2740
Phone (806) 771-7286

Other identifiers 1

IdentifierTypeStateIssuer
106033707MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J8668TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Children'S Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: diane.mcintire@direct.myteamcare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1689698409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5807 63RD ST",
            "address_2": "SUITE 200",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242740",
            "telephone_number": "806-771-7286",
            "fax_number": "806-771-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5807 63RD ST",
            "address_2": "SUITE 200",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242740",
            "telephone_number": "806-771-7286",
            "fax_number": "806-771-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J8668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106033707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.