Individual provider Active NPI

Diane Ferguson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1801534136
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0031531 Issued in OH
Practice address
1112 N 4TH St Ste 313
Columbus, OH 43201-5100
Phone
(614) 311-1230
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 433041 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0031531 OH Primary

Addresses

Primary practice location

1112 N 4TH St Ste 313
Columbus, OH 43201-5100

Mailing address

1112 N 4TH St Ste 313
Columbus, OH 43201-5100
Phone (614) 311-1230

Other practice location 1

4646 Hilton Corporate Dr
Columbus, OH 43232-4147
Phone (614) 845-9798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV, PA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220701002695 OH Practitioner - Nurse Practitioner 4880074244 Reassigns benefits to 3 organizations
I20221209000747 WV Practitioner - Nurse Practitioner 4880074244 Reassigns benefits to 1 organization
I20221227002517 PA Practitioner - Nurse Practitioner 4880074244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CNP Operating Co LLCGroup PAC ID 8325263734, 63 clinicians

Practice addresses (Care Compare)

1599 Alum Creek Dr
Columbus, OH 43209-2596
Phone (614) 643-5454

8055 Addison Rd
Masury, OH 44438-1204
Phone (330) 448-2547

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
433041OHMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Psych. Services PLLC Psychiatric/Mental Health CurrentSince Nov 29, 2022 Accepting new patients
Alcove Ventures LLC Psychiatric/Mental Health CurrentSince Jun 17, 2022 Accepting new patients
P360 Care Services PLLC Dba Psych 360 Psychiatric/Mental Health CurrentSince Dec 14, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Nov 5, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

3567 Reserve Commons Dr
Ste 100
Medina, OH 44256
Phone (330) 664-9250

3593 Medina Rd
Medina, OH 44256
Phone (330) 664-9250

Organizations & group practices 5

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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1801534136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 N 4TH ST STE 313",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432015100",
            "telephone_number": "614-311-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 N 4TH ST STE 313",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432015100",
            "telephone_number": "614-311-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 Hilton Corporate Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432324147",
            "country_code": "US",
            "telephone_number": "614-845-9798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "DIANE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "433041",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0031531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.