Dexter D Dewitt, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

6525 Issued in AZ

Practice address

126 E Main St
Suite B
Payson, AZ 85541-5488

Phone

(928) 468-5437

NPI assigned

Jul 14, 2005

Last updated

Dec 6, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Payson Healthcare Management Inc

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1093718694

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1093714834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829",
            "telephone_number": "615-465-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "SUITE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415488",
            "telephone_number": "928-468-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "DEXTER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "6525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017101703",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0851710",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael D Darnell, DO
• Lori Lynn Davenport, LPC
• Michael Keene Demack, PA C S
• Derek R Sloan DDS PLLC
• Desert Dentistry, PLLC (Desert Dentistry)
• Diana L Easton
• Ryan L Diquattro, DMD
• Diversified Solutions, Inc.
• Lori Dobrowski, PHARMD
• Deborah Ann Dugger, REGISTERED NURSE

• Pediatrics Physician in Payson, AZ
• Providers in Payson, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.