Active NPI
Johnny Dy, MD
- Neurology Physician
- Beckley, WV
National Provider Identifier
1124050562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 10072
- Practice address
- 401 S Kanawha Street
Beckley, WV 25801-3637 - Phone
- (304) 252-0699
- Fax
- (304) 255-6719
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 10072 | WV | Primary |
Addresses
Primary practice location
401 S Kanawha Street
Beckley, WV 25801-3637
Mailing address
2401 S Kanawha Street
Beckly, WV 25801-3637
Phone (304) 252-0699
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0089998000 | Medicaid | WV |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10072 | WV | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1124050562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 S KANAWHA STREET",
"city": "BECKLY",
"state": "WV",
"postal_code": "258013637",
"telephone_number": "304-252-0699",
"fax_number": "304-255-6719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S KANAWHA STREET",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013637",
"telephone_number": "304-252-0699",
"fax_number": "304-255-6719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DY",
"first_name": "JOHNNY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WV",
"license": "10072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0089998000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.