DIANE L SERENSON-UNGAR (NPI# 1245266360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245266360 |
| Entity Type | Individual |
| Full Name | DIANE L SERENSON-UNGAR |
| Credential | APN |
| Practice Address |
2885 W Howard Nickell Rd Fayetteville AR 72704-5459 |
| Practice Telephone | 4794095267 |
| Mailing Telephone | 4794095267 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 330652 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | A001004 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363L00000X | Nurse Practitioner | A01004ANP | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | AR BC/BS | 5T997 | 01 |
| AR | 136354758 | 05 |
| Street Address |
2885 W HOWARD NICKELL RD |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72704-5459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387037 | Anne-ashley Hull | Speech-Language Pathologist | 12905 Randolph Road, Fayetteville, AR 72704 | 2020-05-07 |
| 1427607019 | Destiny Bound, LLC | Midwife | 3825 N Salem Road, Fayetteville, AR 72704 | 2019-09-06 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| 1104319433 | Rise Physical Therapy Pa | Clinic/Center | 3484 W Wedington Dr Ste 4, Fayetteville, AR 72704 | 2018-06-12 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1528410487 | Sharon Byrd | Licensed Practical Nurse | 17836 Harmon Rd, Fayetteville, AR 72704 | 2016-07-05 |
| 1861823502 | Andrea Warren | Pharmacist | 2875 W Martin Luther King Jr Blvd, Fayetteville, AR 72704 | 2013-12-05 |
| 1609157726 | Jessica Rose Collier | Speech-Language Pathologist | 2020 E Joyce Ave., Suite 2, Fayetteville, AR 72704 | 2011-09-02 |
| 1194044941 | Wcnc, Inc. | Skilled Nursing Facility | 4405 Persimmon Street, Fayetteville, AR 72704 | 2010-05-19 |
| 1841512944 | Jill K Johnston | Speech-Language Pathologist | 3472 N Sandpiper Dr, Fayetteville, AR 72704 | 2010-02-17 |
| Find all providers in zip 72704 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326659798 | Derek Miles Anderson | Nurse Practitioner | 545 Woodward Dr, Fayetteville, GA 30215-7641 | 2020-08-11 |
| 1376167163 | Shatanya Monique Cook | Nurse Practitioner | 1233 Highway 54 W Ste 205, Fayetteville, GA 30214-4542 | 2020-06-08 |
| 1063058972 | Mardee L Baxley | Nurse Practitioner | 1991 Fordham Dr Ste 302, Fayetteville, NC 28304-3774 | 2019-11-26 |
| 1336781715 | Anna Brooks Maness Reed | Nurse Practitioner | 2053 Valleygate Dr Ste 102, Fayetteville, NC 28304-3983 | 2019-10-17 |
| 1801362355 | Dawn Stone | Nurse Practitioner | 874 Lanier Ave W Ste 220, Fayetteville, GA 30214-7659 | 2018-10-22 |
| 1902385784 | Yasmin Mathlin | Nurse Practitioner | 641 Walker St, Fayetteville, NC 28311-1990 | 2018-08-12 |
| 1144731951 | Kelli Borland | Nurse Practitioner | 101 Yorktown Dr Ste 207, Fayetteville, GA 30214-1578 | 2017-10-19 |
| 1134639867 | Jeanne Marie Lythgoe | Nurse Practitioner | 2153 Valleygate Dr Ste 101, Fayetteville, NC 28304-3667 | 2017-10-09 |
| 1174048037 | Sharon Davinroy | Nurse Practitioner | 315 Sparrow Dr, Fayetteville, NC 28306-8227 | 2017-08-11 |
| 1609302868 | Rose M Graham | Nurse Practitioner | 1202 Walter Reed Road, Capefear Valley Associate, Fayetteville, NC 28304 | 2017-05-10 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.