Individual provider Active NPI

Dorothy Marie Dator, MA

  • Psychologist
  • Greensboro, NC
National Provider Identifier
1124750088
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
103595 Issued in NC
Practice address
1103 N Elm St
Greensboro, NC 27401-6309
Phone
(336) 272-6161
Fax
(336) 271-3724
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X
Psychologist 103T00000X 103595 NC Primary

Addresses

Primary practice location

1103 N Elm St
Greensboro, NC 27401-6309

Mailing address

801 N 13TH St
Herrin, IL 62948-3246
Phone (336) 970-8821

Other practice location 1

1200 Locust St
Eldorado, IL 62930-1723
Phone (618) 252-9036

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddator713804@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625000077 NC Practitioner - Clinical Psychologist 6608319108 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
103595NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Psychologist Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Psychologist CurrentSince Jun 3, 2024 Accepting new patients
Stress & Trauma Treatment Center, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Moses Cone Physician Services, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Jun 3, 2024 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jun 3, 2024 Accepting new patients

Locations

1200 Locust St
Eldorado, IL 62930
Phone (618) 252-9036

1103 N Elm St
Ste 300
Greensboro, NC 27401
Phone (336) 271-3331

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

1103 N Elm St
Greensboro, NC 27401
Phone (336) 271-3331

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1124750088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N 13TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483246",
            "telephone_number": "336-970-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016309",
            "telephone_number": "336-272-6161",
            "fax_number": "336-271-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Locust St",
            "address_purpose": "LOCATION",
            "city": "Eldorado",
            "state": "IL",
            "postal_code": "629301723",
            "country_code": "US",
            "telephone_number": "618-252-9036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATOR",
        "first_name": "DOROTHY",
        "middle_name": "MARIE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "103595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddator713804@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1103 N Elm St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274016309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.