Diane L Weaver, DNP
Individual provider Active NPI Family Nurse Practitioner · Lisbon, OH
NPI 1902247752 · NPPES record last updated Nov 4, 2015
Key facts
- NPI
- 1902247752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 14665-NP (OH)
- Practice address
- 7880 Lincole PL
Lisbon, OH 44432-8322 - Phone
- (330) 424-5686
- Fax
- (330) 424-4012
- NPI assigned
- Jul 9, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Illumia Health LLC
Wissam Khoury DPM LLC
Apex Physical Medicine, Inc
Practice addresses (Care Compare)
Akron, OH 44333
Phone (330) 576-5405
2475 E 22ND St
Suite 120
Cleveland, OH 44115-3221
Phone (216) 367-9444
3684 Dressler Rd NW
Unit 2B
Canton, OH 44718-2781
Phone (330) 479-9193
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151029001459 | OH | Practitioner - Nurse Practitioner | 0840509022 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14665-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Physical Medicine, Inc | Family | Current |
Accepting new patients |
| Illumia Health LLC | Current |
Accepting new patients | |
| Community Action Agency of Columbiana County Inc | Current |
Accepting new patients | |
| Community Action Agency of Columbiana County Inc | Current |
Accepting new patients | |
| Illumia Health LLC | Current |
Accepting new patients | |
| Columbus Radiology Corp | Past |
Accepting new patients |
Locations
655 Brawley School Rd
Ste 200
Mooresville, NC 28117
4040 Embassy Pkwy
Ste 410
Akron, OH 44333
Phone (330) 576-5405
3700 Embassy Pkwy
Ste 130
Akron, OH 44333
Phone (330) 576-5405
3684 Dressler Rd NW
#2B
Canton, OH 44718
Phone (330) 479-9193
7880 Lincole Pl
Lisbon, OH 44432
Phone (330) 424-5686
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14665-NP | OH | Yes |
Addresses
Primary practice location
7880 Lincole PL
Lisbon, OH 44432-8322
Mailing address
7880 Lincole PL
Lisbon, OH 44432-8322
Phone (330) 424-7221
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0115767 | Medicaid | OH |
Other providers in Lisbon, OH
- David Wallenhurst
- Matthew Ray Warren
- Taylor Watson
- Anthony James Watt
- Larisa Rachael Watt
- Tammy Welch
- Marilyn Wells
- Linda Wentzel
- West Point Volunteer Fire Department Inc
- Brianne Williams
All providers in Lisbon, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.