Individual provider Active NPI

Dean G. Gianakos, M.D.

  • Internal Medicine Physician
  • Lynchburg, VA
National Provider Identifier
1215936067
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101039392 Issued in VA
Practice address
2323 Memorial Ave
Suite 10
Lynchburg, VA 24501-2661
Phone
(434) 200-5200
NPI assigned
Jul 14, 2005
Last updated
Jun 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
010141826MedicaidVA
541457983OtherTRICARE PROVIDER NUMBER
541457983OtherPCHP PROVIDER NUMBER
006009832MedicaidVA
180728OtherSOUTHERN HEALTH PROVIDER
40870OtherMEDCOST PROVIDER NUMBER
700010617OtherCIGNA PROVIDER NUMBER
45436OtherSENTARA/OPTIMA PROVIDER N
60-0983-2OtherVA PREMIER PROVIDER NUMBE
04-03151OtherUNITED HEALTHCARE PROVIDE
086705OtherANTHEM 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

LicenseStateTypeSpecialty
0101039392VAMDInternal 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.

Verify at the official NPI Registry.