Diane Lynn Roche, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3209 Issued in TN

Practice address

1500 W Elk Ave
Elizabethton, TN 37643

Phone

(423) 543-2584

Fax

(423) 722-2060

NPI assigned

Feb 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN, AK2 enrollments

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 2

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Municipality of SkagwayGroup PAC ID 0244227726, 12 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.39 of 100Reported as group

Quality

86.98

Promoting interoperability

92

Improvement activities

40

Cost

80.98

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: diane.roche.1@15635.direct.athenahealth.com

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.

• Municipality of Skagway

  • Federally Qualified Health Center (FQHC)
  • Skagway, AK
  • NPI 1063574200
  Medicare reassignment Care Compare group NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232

  Physician Assistant

  Medicare reassignment NPD
• Ipc Pac Healthcare Services of Tennessee PC

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1104277656
  Medicare reassignment
• Medical Care PLLC

  • Family Medicine Physician
  • Elizabethton, TN
  • NPI 1851537260
  Medicare reassignment
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  TN

  Medicare reassignment
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1952840647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432654",
            "telephone_number": "423-543-2584",
            "fax_number": "423-722-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-543-2584",
            "fax_number": "423-722-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 14th Ave",
            "address_2": "POB 537",
            "address_purpose": "LOCATION",
            "city": "Skagway",
            "state": "AK",
            "postal_code": "99587",
            "country_code": "US",
            "telephone_number": "907-983-2255",
            "fax_number": "907-983-2793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "DIANE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA3209",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "208943",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1749627",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029831",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riverside Pedatrics PLLC
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• Kristie Dawn Roberts
• Robertson Dental PLLC
• Mark Alan Robertson, D.D.S.
• Kaylee Rose, M.S., CF-SLP
• Larry James Rose, L.C.S.W.
• Faith Russell, PT, DPT
• Christine Marie Sager, M.D.
• Kimberly Ann Sams, ASSOC

• Physician Assistant in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.