Individual provider Active NPI

Diana Sullivan Neff, PMHNP

  • Nurse Practitioner
  • Caldwell, ID
National Provider Identifier
1699120113
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
67425 Issued in ID
Practice address
808 Cleveland Blvd
Caldwell, ID 83605-4168
Phone
(208) 459-1025
Fax
(208) 466-5359
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 324463-3102 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 324463-4405 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 67425 ID
Nurse Practitioner 363L00000X 67425 ID Primary

Addresses

Primary practice location

808 Cleveland Blvd
Caldwell, ID 83605-4168

Mailing address

PO Box 9
Nampa, ID 83653-0009
Phone (208) 461-7149

Other practice location 1

1401 N 1075 W Ste 240
Farmington, UT 84025-2745
Phone (801) 613-8178

Other practice location 2

6348 W Emerald St
Boise, ID 83704-8732
Phone (208) 302-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180523002326 UT Practitioner - Nurse Practitioner 3678838547 Reassigns benefits to 2 organizations
I20210528001594 ID Practitioner - Nurse Practitioner 3678838547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

150 2ND St
Melba, ID 83641-5199
Phone (208) 495-1011

808 Cleveland Blvd
Caldwell, ID 83605-4168
Phone (208) 459-1025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324463-3102UTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. Nurse Practitioner Current Accepting new patients
Community Health Clinics, Inc. CurrentSince Mar 18, 2024 Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Apr 15, 2019 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Apr 15, 2019 Accepting new patients
Community Health Clinics, Inc. Nurse Practitioner CurrentSince Mar 18, 2024 Accepting new patients
University of Utah Pediatric Behavioral Health Services Current Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Apr 15, 2019 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Apr 15, 2019 Accepting new patients
University of Utah Behavioral Health Services Current Accepting new patients
Community Health Clinics, Inc. Nurse Practitioner Past Accepting new patients
Feller Behavioral Health Services PastSince Jun 28, 2022 Accepting new patients
Alliance Medical Group, LLC Past Accepting new patients

Locations

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

207 1st St S
Nampa, ID 83651
Phone (208) 318-1376

525 E 100 S
Ste 500
Salt Lake City, UT 84102
Phone (801) 519-7190

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: dneff1563187@direct.trinity-health.org

Organizations & group practices 12

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1699120113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-461-7149",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054168",
            "telephone_number": "208-459-1025",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 N 1075 W Ste 240",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "UT",
            "postal_code": "840252745",
            "country_code": "US",
            "telephone_number": "801-613-8178",
            "fax_number": "801-992-1218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6348 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048732",
            "country_code": "US",
            "telephone_number": "208-302-0900",
            "fax_number": "208-302-0955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEFF",
        "first_name": "DIANA",
        "middle_name": "SULLIVAN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "324463-3102",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "324463-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "67425",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "67425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.