Diane E Waddell, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

121001 Issued in MO

Practice address

5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754

Phone

(816) 271-7169

NPI assigned

Jul 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891728408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5514 CORPORATE DR STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077754",
            "telephone_number": "816-271-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5514 CORPORATE DR STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077754",
            "telephone_number": "816-271-7169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5210 N. Belt Highway",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063511",
            "country_code": "US",
            "telephone_number": "816-627-1883",
            "fax_number": "816-271-8831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "DIANE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "121001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200265100A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "10001677501",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201060639",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryon Keith Vogt, DO
• Ion Volosenco
• Albert Frank Voltolina Jr., RPH
• Amelia Vopat
• Tiffany J. Vorderstrasse, FNP
• Patricia Waddell, F.N.P.
• Scott Alan Wade, M.D.
• Casey Rae Wagner, APRN
• Bryson Andrew Waitkoss, DPT
• Hayley Reanne Waitkoss, DPT, PT

• Family Nurse Practitioner in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.