Individual provider Active NPI

Diana L Halback, CPNP-PC, CPNP-AC

  • Pediatric Nurse Practitioner
  • Frisco, TX
National Provider Identifier
1871772806
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
687839 Issued in TX
Practice address
5700 Dallas Pkwy
Frisco, TX 75034-9580
Phone
(469) 515-7100
Fax
(469) 515-7101
NPI assigned
Oct 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 687839 TX Primary

Addresses

Primary practice location

5700 Dallas Pkwy
Frisco, TX 75034-9580

Mailing address

2222 Welborn St
Dallas, TX 75219-3924
Phone (214) 559-5000

Other identifiers 1

IdentifierTypeStateIssuer
206247308MedicaidTX

Other names 1

  • Miss Diana L Beaty Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090429000586 TX Practitioner - Nurse Practitioner 7517015639 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
687839TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pedi-Ortho Health Corporation CurrentSince Oct 1, 2022 Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

Interoperability endpoints

  • Direct secure messaging: diana.halback@hca7.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1871772806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 DALLAS PKWY",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349580",
            "telephone_number": "469-515-7100",
            "fax_number": "469-515-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALBACK",
        "first_name": "DIANA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "687839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206247308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BEATY",
            "middle_name": "L",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.