John Ditraglia Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

35047660 Issued in OH

Legal business name

JOHN DITRAGLIA INC

Practice address

717 5TH St
Portsmouth, OH 45662-4007

Phone

(740) 354-6605

Fax

(740) 354-1565

NPI assigned

May 10, 2007

Last updated

Mar 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Francis Ditraglia, MDNPI 1447349956

Title

Owner

Phone

(740) 354-6605

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093920506. Details of each certification follow.

• CCN 363874 Rural health clinic · Active · Details

Rural health clinic certification: CCN 363874

Legal name

JOHN DITRAGLIA INC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Sep 4, 2019

Last certification

Sep 4, 2019

Ownership / control type

1A

Organization structure

CorporationProprietary

Incorporated

Oct 10, 2014 in OH

Enrollment address

717 5TH St
Portsmouth, OH 45662-4007

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Francis Ditraglia, MD

  • Pediatrics Physician
  • Portsmouth, OH
  • NPI 1447349956
  NPD Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552867200000",
    "number": "1093920506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 5TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624007",
            "telephone_number": "740-354-6605",
            "fax_number": "740-354-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 5TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624007",
            "telephone_number": "740-354-6605",
            "fax_number": "740-354-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN DITRAGLIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2019-03-18",
        "status": "A",
        "authorized_official_last_name": "DITRAGLIA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-354-6605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "35047660",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OH",
            "license": "35047660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64781438",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Beth Jenkins
• Tristin Fay Jenkins
• Jennifer D. Roberts DO LLC
• Amanda Jimison
• Jitendra K. Patel M.D. Inc
• John Evans MD Ophthalmology Inc
• Amanda Johnson
• Brad Anothy Johnson, D.C.
• Brock A Johnson, MD
• Danae Lee Johnson

• Primary Care Clinic/Center in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.