John James Ditmars, Jr. DPM, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

142 Issued in OK

Legal business name

JOHN JAMES DITMARS, JR. DPM, PC

Practice address

1620 W Elm St
El Reno, OK 73036-4202

Phone

(405) 262-6613

Fax

(405) 262-1088

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John James Ditmars Jr., DPMNPI 1033140983

Title

President

Phone

(405) 262-6613

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• John James Ditmars, Jr. DPM PC

  • Durable Medical Equipment & Medical Supplies
  • Yukon, OK
  • NPI 1669642351

  3072646595

  Same PAC ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John James Ditmars Jr., DPM

  • Podiatrist
  • El Reno, OK
  • NPI 1033140983
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1023286382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 717",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730360717",
            "telephone_number": "405-262-6613",
            "fax_number": "405-262-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W ELM ST",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730364202",
            "telephone_number": "405-262-6613",
            "fax_number": "405-262-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN JAMES DITMARS, JR. DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "DITMARS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-262-6613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OK",
            "license": "142",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200275890 B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in El Reno, OK
• Providers in El Reno, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.