NPIMap

Individual provider Active NPI

John J Dreyzehner, MD

  • Specialist
  • Lebanon, VA
National Provider Identifier
1003885245
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101046203 Issued in VA
Practice address
155 Rogers St
Box 2347
Lebanon, VA 24266-4501
Phone
(276) 889-7621
Fax
(276) 889-7695
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101046203 VA Primary

Addresses

Primary practice location

155 Rogers St
Box 2347
Lebanon, VA 24266-4501

Mailing address

22622 Red Wolf Dr
Abingdon, VA 24211-5593
Phone (276) 889-7621

Other identifiers 1

IdentifierTypeStateIssuer
004975085MedicaidVA

Other names 1

  • John J Dreyzehner Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Department of Health Past Accepting new patients
Commonwealth of Virginia State Board of Health Past Accepting new patients
Virginia Department of Health Past Accepting new patients
Commonwealth of Virginia State Board of Health Past Accepting new patients
Russell County Dental Clinic Past Accepting new patients
Commonwealth of Virginia State Board of Health Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1003885245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22622 RED WOLF DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242115593",
            "telephone_number": "276-889-7621",
            "fax_number": "276-889-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ROGERS ST",
            "address_2": "BOX 2347",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664501",
            "telephone_number": "276-889-7621",
            "fax_number": "276-889-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYZEHNER",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101046203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004975085",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "DREYZEHNER",
            "middle_name": "J",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.