Deactivated NPI 1104356302 Deactivated / Inactive NPI Female Practitioner

Betsy Diaz , FNP-C

Nurse Practitioner • Shellman, GA

✓ Accepts Medicare Assignment

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Betsy Diaz has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 20, 2017

NPI Deactivation Date September 18, 2021

Total Practice Duration ~4 Years of Practice (2017 – 2021)

Professional Overview & Biography Verified Profile Summary

Betsy Diaz, FNP-C was a registered Nurse Practitioner practicing in Shellman, GA. Throughout an active medical career spanning 4 years, Betsy Diaz provided care at the practice location at 67 W RAILROAD ST until profile deactivation on 2021-09-18.

Betsy Diaz was affiliated with Rural Urgent Care Llc and accepted Medicare assignment.

Historical Medicare Part B clinical services included injection, dexamethasone sodium phosphate, 1 mg, detection test by immunoassay with direct visual observation for influenza virus, injection beneath the skin or into muscle for therapy, diagnosis, or prevention. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

67 W Railroad St

Shellman, GA 398863100

Telephone 2296792100

Associated Practice Facility / Clinic

🏢 Kjh Medical Services Facility NPI 1912481482

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Shellman, GA

Experienced Practitioner (5-10 Yrs)

Practitioner Clinical Experience

9 Yrs Matches City Avg

City Avg: 9.0 Yrs

State Avg: 10.5 Yrs

Regional Practice Density

2 Specialists

Practicing in Shellman, GA (3149 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

61.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Diaz (9 Years) 9 Yrs

Shellman Specialty Average (9.0 Years) 9.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1100 Injection, dexamethasone sodium phosphate, 1 mg	469	56	$10.00	$0.11
87804 Detection test by immunoassay with direct visual observation for influenza virus	166	75	$35.00	$15.83
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	105	76	$50.00	$10.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	93	93	$332.00	$126.79
J0696 Injection, ceftriaxone sodium, per 250 mg	92	22	$10.00	$0.45
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	82	74	$70.00	$39.56
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	74	69	$43.00	$15.76
71046 X-ray of chest, 2 views	63	57	$103.00	$25.01
87634 Detection test by nucleic acid for respiratory syncytial virus, amplified probe technique	60	56	$100.00	$68.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	43	$218.32	$98.16
81003 Automated urinalysis test	21	17	$22.00	$2.20
J1885 Injection, ketorolac tromethamine, per 15 mg	18	13	$50.00	$0.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1100 Injection, dexamethasone sodium phosphate, 1 mg	196	26	$10.00	$0.10
87804 Detection test by immunoassay with direct visual observation for influenza virus	110	55	$35.00	$15.22
J0696 Injection, ceftriaxone sodium, per 250 mg	96	24	$10.00	$0.50
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	68	52	$50.00	$10.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	68	68	$332.00	$126.85
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	51	51	$43.00	$15.12
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	51	51	$59.29	$37.56
71046 X-ray of chest, 2 views	44	44	$103.00	$24.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	37	$216.00	$96.96
J1885 Injection, ketorolac tromethamine, per 15 mg	28	15	$50.00	$0.57
81003 Automated urinalysis test	18	18	$22.00	$2.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1100 Injection, dexamethasone sodium phosphate, 1 mg	268	30	$10.00	$0.12
87804 Detection test by immunoassay with direct visual observation for influenza virus	82	41	$35.00	$16.26
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	67	47	$50.00	$11.53
J0696 Injection, ceftriaxone sodium, per 250 mg	56	14	$10.00	$0.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	55	53	$216.00	$104.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$332.00	$136.65
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	38	37	$49.00	$40.62
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	36	36	$43.00	$16.25
J1885 Injection, ketorolac tromethamine, per 15 mg	30	16	$50.00	$0.58
81003 Automated urinalysis test	20	18	$22.00	$2.20
71046 X-ray of chest, 2 views	17	17	$103.00	$26.80
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	16	16	$49.00	$34.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	29	$248.86	$105.20
36415 Insertion of needle into vein for collection of blood sample	13	11	$28.00	$3.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	58	23	$250.00	$89.52
36415 Insertion of needle into vein for collection of blood sample	27	18	$28.00	$2.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$350.00	$135.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	206	134	$150.00	$88.41
36415 Insertion of needle into vein for collection of blood sample	92	68	$25.00	$2.94
81003 Automated urinalysis test	25	20	$24.00	$2.44
71046 X-ray of chest, 2 views	17	16	$71.00	$18.60
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	14	$40.00	$13.31
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	13	13	$106.00	$93.60
G0009 Administration of pneumococcal vaccine	12	12	$26.00	$15.59
G0444 Annual depression screening, 5 to 15 minutes	11	11	$42.00	$14.36
99497 Advance care planning, first 30 minutes	11	11	$215.00	$69.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	177	125	$148.14	$87.45
36415 Insertion of needle into vein for collection of blood sample	50	43	$25.00	$2.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	38	38	$106.00	$94.25
99497 Advance care planning, first 30 minutes	38	38	$215.00	$69.59
G0444 Annual depression screening, 5 to 15 minutes	35	35	$42.00	$14.35
81003 Automated urinalysis test	26	21	$24.00	$2.71
99213 Established patient office or other outpatient visit, typically 15 minutes	14	13	$100.00	$59.15
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg	13	12	$12.00	$6.85
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	11	11	$40.00	$16.27
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	11	11	$26.00	$11.89

Medical Specialties & State Licenses

CMS Verified: 2025-09-18

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License GA RN133959

(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.

Nurse Practitioner - Family

NUCC Taxonomy Code: 363LF0000X

State License FL APRN11042326

Definition to come...

Nurse Practitioner - Family

NUCC Taxonomy Code: 363LF0000X

State License AL 1-144325

Definition to come...

Hospital & Practice Group Affiliations

Rural Urgent Care Llc

1026 S Eufaula Ave, Eufaula, AL 360272702

Phone: 3346894025

Rural Urgent Care Llc

1730 Pat Thomas Pkwy, Quincy, FL 323518681

Phone: 8506620041

Rural Urgent Care Llc

1245 Noah Dr, Jasper, GA 301438721

Phone: 7062531954

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Tiffany Garland , NP-C

Nurse Practitioner

NPI 1659967495

Nurse Practitioner (Certified)

Jessica Faust , RN, FNP-C

Nurse Practitioner - Family

NPI 1942658125

Registered Nurse, Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

22 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 18, 2025

Nurse Practitioner (License #APRN11042326 in FL)

📍

Updated Business Mailing Address January 25, 2022

Registered at 1500 1ST AVE N, UNIT 3, BIRMINGHAM, AL 352031866 (Tel: 2055455088)

📍

Updated Practice Location October 18, 2021

Registered at 67 W RAILROAD ST, SHELLMAN, GA 398863100 (Tel: 2296792100)

📍

Updated Business Mailing Address October 18, 2021

Registered at 67 W RAILROAD ST, SHELLMAN, GA 398863100 (Tel: 2296792100)

👤

Provider Name / Credentials Updated October 18, 2021

Recorded as BETSY DIAZ, FNP-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 18, 2021

Nurse Practitioner (License #RN133959 in GA)

⚠️

NPI Profile Deactivated September 18, 2021

Record deactivated on September 18, 2021

📍

Updated Practice Location January 15, 2020

Registered at 67 W RAILROAD ST, SHELLMAN, GA 398863100 (Tel: 2296792100)

📍

Updated Business Mailing Address January 15, 2020

Registered at 67 W RAILROAD ST, SHELLMAN, GA 398863100 (Tel: 2296792100)

📍

Updated Practice Location January 16, 2019

Registered at 1390 US HIGHWAY 19 S, LEESBURG, GA 317634831 (Tel: 2293127490)

📍

Updated Business Mailing Address January 16, 2019

Registered at 500 W 3RD AVE STE 101, ALBANY, GA 317011900 (Tel: 2293125802)

✅

NPI Profile Active July 17, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location July 17, 2017

Registered at 425 W 3RD AVE, ALBANY, GA 317011941 (Tel: 2293121000)

📍

Updated Business Mailing Address July 17, 2017

Registered at 425 WEST THIRD AVENUE, PHOEBE PUTNEY MEMORIAL HOSPITAL, SURGICARE DEPART., ALBANY, GA 31701

👤

Provider Name / Credentials Updated July 17, 2017

Recorded as BETSY DIAZ, FNP-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2017

Nurse Practitioner (License #RN133959 in GA)

✅

NPI Profile Active June 20, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location June 20, 2017

Registered at 185 WINNSTEAD DR, LEESBURG, GA 317635326 (Tel: (229) 869-2229)

📍

Updated Business Mailing Address June 20, 2017

Registered at 185 WINNSTEAD DR, LEESBURG, GA 317635326 (Tel: 2298692229)

👤

Provider Name / Credentials Updated June 20, 2017

Recorded as BETSY DIAZ, FNP-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2017

Nurse Practitioner (License #RN133959 in GA)

🟢

Initial NPI Registration & Enumeration June 20, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Betsy Diaz. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1104356302

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 20, 2017

Last Update: September 18, 2025

Deactivation Date: September 18, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1500 1st Ave N, Unit 3

Birmingham, AL 352031866

Phone: 2055455088

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.