Diane Dabit Sackleh, ARPN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1079744 Issued in KY

Practice address

26 N Highland St
Winchester, KY 40391-2024

Phone

(859) 253-1686

Fax

(859) 254-2743

NPI assigned

Feb 8, 2007

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Vpa PC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1336153295
  NPD (past)
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992846679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111217",
            "telephone_number": "859-253-1686",
            "fax_number": "859-254-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N HIGHLAND ST",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912024",
            "telephone_number": "859-253-1686",
            "fax_number": "859-254-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKLEH",
        "first_name": "DIANE",
        "middle_name": "DABIT",
        "name_prefix": "Mrs.",
        "credential": "ARPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "1079744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly M Rogers, MD
• Sydney Rogers
• Ronald Fulkerson MD PSC
• Roumanos Rehabilitation, PA
• Amber D Rudd, APRN
• Anna Marie Salyer
• Samantha Mills, LCSW, LLC
• Michelle D Sames, LPCC-S
• Estelle Athalene Saylor-Pavkovich, PT, DPT
• Matthew Schaffer

• All providers in Winchester, KY
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.