DIANA SMITH (NPI# 1689948424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689948424 |
| Entity Type | Individual |
| Full Name | DIANA SMITH |
| Practice Address |
56 Club Manor Dr Suite 100 Pueblo CO 81008-1685 |
| Mailing Address |
Po Box 560825 Denver CO 80256-0825 |
| Practice Telephone | 7195844767 |
| Practice Fax Number | 7195957906 |
| Mailing Telephone | 7195957580 |
| Mailing Fax Number | 7195450176 |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2016-07-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC1500X |
Registered Nurse Specialization: Community Health |
RN81430 | CO | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
991239 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
APN.0991239-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 39278352 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053859462 | Diana Joye Smith | Nurse Practitioner | 43 Yu Dr Ste 2, New Braunfels, TX 78130-2458 | 2017-02-06 |
| 1790032837 | Diana Renee Smith | Marriage & Family Therapist | 1738 S. Tremont St, Oceanside, CA 92054 | 2012-08-08 |
| 1316175599 | Diana Lee Smith | Case Manager/Care Coordinator | 851 South St, Wheatland, WY 82201-2953 | 2009-06-26 |
| 1467632356 | Diana Bowers Smith | Local Education Agency (LEA) | 108 Walnut St, Pendleton County Board of Education, Franklin, WV 26807-0888 | 2007-11-07 |
| 1750433629 | Diana Marie Smith | Counselor | 6613 Eastridge Rd, Black Hawk, SD 57718-8335 | 2007-01-18 |
| 1720199631 | Diana Smith | Physical Therapist | 1875 N Lakewood Dr Ste 101, Coeur D Alene, ID 83814-4928 | 2006-08-31 |
| 1033745542 | Diana Michelle Smith | Counselor | 410 S Orchard St Ste 128, Boise, ID 83705-1288 | 2020-03-16 |
| 1720612427 | Diana Smith | Behavioral Analyst | 1441 E Ft Union Blvd, Cottonwood Heights, UT 84121-2847 | 2020-03-03 |
| 1447731906 | Diana Christine Smith | Pharmacy Technician | 2219 12th Ave Rd, Nampa, ID 83686-6313 | 2018-08-23 |
| 1952834483 | Diana Smith | Occupational Therapist | 9515 Horace Harding Expy, Corona, NY 11368-4154 | 2017-04-11 |
| Street Address |
56 CLUB MANOR DR SUITE 100 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093743247 | Susan R. Middleton | Psychiatry & Neurology | 56 Club Manor Dr, Pueblo, CO 81008-1679 | 2006-06-28 |
| 1619305950 | Musharraf A. Nizami, M.d. PC | Psychiatry & Neurology | 56 Club Manor Dr, Suite 100, Pueblo, CO 81008-1679 | 2013-10-24 |
| 1609193457 | Tanya Dawn Hand | Counselor | 56 Club Manor Dr, Suite 100, Pueblo, CO 81008-1679 | 2010-05-03 |
| 1366672719 | Jessica L Cummings | Nurse Practitioner | 56 Club Manor Dr, Suite 100, Pueblo, CO 81008-1685 | 2009-07-20 |
| 1992972731 | Parkview Ancillary Services | Psychologist | 56 Club Manor Dr, Ste 100, Pueblo, CO 81008-1679 | 2008-05-12 |
| 1154483071 | Daphyne Joy Jillson | Counselor | 56 Club Manor Dr, Suite 100, Pueblo, CO 81008 | 2006-12-15 |
| 1447325097 | Front Range Psychiatric Associates, P.C. | Psychiatry & Neurology | 56 Club Manor Dr, 100, Pueblo, CO 81008-1679 | 2006-11-21 |
| 1144317785 | Musharraf Ashrof Nizami | Psychiatry & Neurology | 56 Club Manor Dr, Suite 100, Pueblo, CO 81008-1679 | 2006-10-06 |
| 1669568556 | Steven Dana Martin | Psychiatry & Neurology | 56 Club Manor Dr, Suite 100, Pueblo, CO 81008-1679 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972050615 | Jodi R Trujillo | Nurse Practitioner | 37 S Briarwood Pl, Pueblo, CO 81005-1803 | 2016-09-09 |
| 1851831846 | Annabelle Florez | Nurse Practitioner | 1600 W 24th St, Pueblo, CO 81003-1411 | 2017-02-24 |
| 1871950493 | Wendy Wade | Nurse Practitioner | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2016-01-27 |
| 1437554557 | Alison Shapiro | Nurse Practitioner | 56 Club Manor Drive, Suite 100, Pueblo, CO 81008-1685 | 2014-10-31 |
| 1114357183 | Leslie Ann Branick Morrow | Nurse Practitioner | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2013-11-12 |
| 1811233448 | Slawomir Tycner | Nurse Practitioner | 1600 W 24th St, Pueblo, CO 81003-1411 | 2012-12-31 |
| 1760730295 | Brenda Jean Mcbride-wilson | Nurse Practitioner | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2012-08-15 |
| 1578810750 | Lorrie J. Hoffman | Nurse Practitioner | 1600 W 24th St, Pueblo, CO 81003-1411 | 2012-08-07 |
| 1013283241 | Monica A Flynn | Nurse Practitioner | 41 Montebello Rd, Pueblo, CO 81001-1379 | 2012-04-02 |
| 1073833273 | Janice Mary Whiting | Nurse Practitioner | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2010-06-10 |
| Find all providers in PUEBLO | ||||
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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.