Individual provider Active NPI

Christine Renee Dively, FNP-C

  • Family Nurse Practitioner
  • Altoona, PA
National Provider Identifier
1851289060
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP033174 Issued in PA
Practice address
1341 N 7TH Ave
Altoona, PA 16601-6208
Phone
(814) 931-1179
Fax
(814) 931-1179
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP033174 PA Primary

Addresses

Primary practice location

1341 N 7TH Ave
Altoona, PA 16601-6208

Mailing address

1341 N 7TH Ave
Altoona, PA 16601-6208
Phone (814) 931-1179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251111002904 PA Practitioner - Nurse Practitioner 7719478395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rollins Ventures LLCGroup PAC ID 7911437165, 5 clinicians

Practice addresses (Care Compare)

3059 Everett Rd
East Freedom, PA 16637-8023
Phone (814) 317-5550

Hospital & facility affiliations

  • Conemaugh Nason Medical Center Hospital, Roaring Spring, PA, CCN 390062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP033174PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rollins Ventures LLC CurrentSince Sep 10, 2025 Accepting new patients
Medroof Primary Care PLLC CurrentSince Sep 10, 2025 Accepting new patients

Locations

3059 Everett Rd
East Freedom, PA 16637
Phone (347) 236-5800

Organizations & group practices 2

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1851289060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 N 7TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166016208",
            "telephone_number": "814-931-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 N 7TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166016208",
            "telephone_number": "814-931-1179",
            "fax_number": "814-931-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVELY",
        "first_name": "CHRISTINE",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP033174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.