Active NPI
Dean G. Gianakos, M.D.
- Internal Medicine Physician
- Lynchburg, VA
National Provider Identifier
1215936067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101039392
- Practice address
- 2323 Memorial Ave
Suite 10
Lynchburg, VA 24501-2661 - Phone
- (434) 200-5200
- NPI assigned
- Jul 14, 2005
- Last updated
- Jun 30, 2009
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101039392 | VA | Primary |
Addresses
Primary practice location
2323 Memorial Ave
Suite 10
Lynchburg, VA 24501-2661
Mailing address
1204 Fenwick Dr
Lynchburg, VA 24502-2112
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010141826 | Medicaid | VA | |
| 541457983 | Other | TRICARE PROVIDER NUMBER | |
| 541457983 | Other | PCHP PROVIDER NUMBER | |
| 006009832 | Medicaid | VA | |
| 180728 | Other | SOUTHERN HEALTH PROVIDER | |
| 40870 | Other | MEDCOST PROVIDER NUMBER | |
| 700010617 | Other | CIGNA PROVIDER NUMBER | |
| 45436 | Other | SENTARA/OPTIMA PROVIDER N | |
| 60-0983-2 | Other | VA PREMIER PROVIDER NUMBE | |
| 04-03151 | Other | UNITED HEALTHCARE PROVIDE | |
| 086705 | Other | ANTHEM PROVIDER NUMBER |
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 |
|---|---|---|---|
| 0101039392 | VA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1215936067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 FENWICK DR",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245022112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 MEMORIAL AVE",
"address_2": "SUITE 10",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245012661",
"telephone_number": "434-200-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIANAKOS",
"first_name": "DEAN",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101039392",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010141826",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE PROVIDER NUMBER",
"identifier": "541457983",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCHP PROVIDER NUMBER",
"identifier": "541457983",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006009832",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH PROVIDER",
"identifier": "180728",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST PROVIDER NUMBER",
"identifier": "40870",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "700010617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA/OPTIMA PROVIDER N",
"identifier": "45436",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA PREMIER PROVIDER NUMBE",
"identifier": "60-0983-2",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PROVIDE",
"identifier": "04-03151",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "086705",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynchburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.