Jennifer George Dittes, PA-C

Key facts

NPI

1154493237

Entity type

Individual (NPI type 1)

Primary specialty

Physician Assistant 363A00000X

License

701PA (TN)

Practice address

1124 New Highway 52 E
Westmoreland, TN 37186-5060

Phone

(615) 644-2000

Fax

(615) 644-2078

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Wellness Family Practice, PA Family Medicine Physician · Cary, NC · NPI 1285844662
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jennifer.dittes@hfh.eclinicaldirectplus.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 17, 2017.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1154493237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 NEW HIGHWAY 52 E",
            "city": "WESTMORELAND",
            "state": "TN",
            "postal_code": "371865060",
            "telephone_number": "615-644-2000",
            "fax_number": "615-644-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 NEW HIGHWAY 52 E",
            "city": "WESTMORELAND",
            "state": "TN",
            "postal_code": "371865060",
            "telephone_number": "615-644-2000",
            "fax_number": "615-644-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTES",
        "first_name": "JENNIFER",
        "middle_name": "GEORGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "701PA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4097035",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Westmoreland, TN · Physician Assistant in Tennessee