Individual provider Active NPI

Diane R Charlton, RN

  • Psychiatric/Mental Health Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1811047301
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
287362-1 Issued in NY
Practice address
375 Pearl St
Brooklyn, NY 11201-3706
Phone
(718) 852-1029
NPI assigned
Jan 10, 2007
Reactivated
Dec 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 287362-1 NY Primary

Addresses

Primary practice location

375 Pearl St
Brooklyn, NY 11201-3706

Mailing address

375 Pearl St
Brooklyn, NY 11201-3706

Other identifiers 1

IdentifierTypeStateIssuer
287362-1OtherNYREGISTERED NURSE

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
287362-1NYMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1811047301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 PEARL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 PEARL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013706",
            "telephone_number": "718-852-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "DIANE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2019-12-03",
        "deactivation_date": "2017-11-06",
        "reactivation_date": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "287362-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "287362-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.