Individual provider Active NPI

Diane Leslie Roberts, PCNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Providence, RI
National Provider Identifier
1942265749
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
PPNS00060 Issued in RI
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

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
26915RIMDRegistered Nurse
PPNS00060RIMDPsychiatric/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.

Verify at the official NPI Registry.