Individual provider Active NPI

Diana Lee Reardon, CRNA

  • Certified Registered Nurse Anesthetist
  • Greensboro, NC
National Provider Identifier
1750450458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43203 Issued in NC
Practice address
501 N Elam Ave
Greensboro, NC 27403-1118
Phone
(336) 832-1000
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 43203 NC Primary

Addresses

Primary practice location

501 N Elam Ave
Greensboro, NC 27403-1118

Mailing address

PO Box 26580
Greensboro, NC 27415-6580
Phone (336) 832-7786

Other identifiers 1

IdentifierTypeStateIssuer
8051068MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229000079 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365630787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

509 E N Elam Ave
FL 3
Greensboro, NC 27403-1118
Phone (336) 832-1970

618 S Main St
Reidsville, NC 27320-5020
Phone (336) 938-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1185NCMDAddiction (Substance Use Disorder) Counselor
43203NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Feb 1, 2023 Accepting new patients

Locations

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750450458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26580",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274156580",
            "telephone_number": "336-832-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N ELAM AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031118",
            "telephone_number": "336-832-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "DIANA",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "43203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051068",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.