Active NPI
Diane Leslie Roberts, PCNS
- Psychiatric/Mental Health Nurse Practitioner
- Providence, RI
National Provider Identifier
1942265749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- PPNS00060
- Practice address
- Department of Veterans Affairs Medical Center, Mhbss
830 Chalkstone Avenue
Providence, RI 02908-4799 - Phone
- (401) 273-7100
- Fax
- (401) 457-3371
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | PPNS00060 | RI | Primary |
| Registered Nurse | 163W00000X | 26915 | RI |
Addresses
Primary practice location
Department of Veterans Affairs Medical Center, Mhbss
830 Chalkstone Avenue
Providence, RI 02908-4799
Mailing address
79 Lakeside Avenue
Cranston, RI 02910-2314
Phone (401) 781-0085
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)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26915 | RI | MD | Registered Nurse |
| PPNS00060 | RI | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323129600000",
"number": "1942265749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 LAKESIDE AVENUE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029102314",
"telephone_number": "401-781-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, MHBSS",
"address_2": "830 CHALKSTONE AVENUE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029084799",
"telephone_number": "401-273-7100",
"fax_number": "401-457-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DIANE",
"middle_name": "LESLIE",
"name_prefix": "Ms.",
"credential": "PCNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-18",
"last_updated": "2011-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "RI",
"license": "PPNS00060",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "RI",
"license": "26915",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.