Individual provider Active NPI

John Frank Dishuck, MD

  • Allergy & Immunology Physician
  • Tuscaloosa, AL
National Provider Identifier
1225019706
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
12867 Issued in AL
Practice address
535 Jack Warner Pkwy NE
Suite C
Tuscaloosa, AL 35404-5751
Phone
(205) 553-2252
Fax
(205) 553-3326
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 12867 AL Primary

Addresses

Primary practice location

535 Jack Warner Pkwy NE
Suite C
Tuscaloosa, AL 35404-5751

Mailing address

535 Jack Warner Pkwy NE
Suite C
Tuscaloosa, AL 35404-5751
Phone (205) 553-2252

Other identifiers 2

IdentifierTypeStateIssuer
51083745OtherALBC/BS ALABAMA
83745MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121211000200 AL Practitioner - Allergy/Immunology 1759533128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of South Alabama College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

535 Jack Warner Pkwy NE
Tuscaloosa, AL 35404-5715
Phone (205) 553-2252

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy & Asthma Ctr of Tuscaloosa, PC Allergy & Immunology CurrentSince Jul 1, 1991 Accepting new patients

Locations

535 Jack Warner Pkwy NE
Ste C
Tuscaloosa, AL 35404
Phone (205) 553-2252

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1225019706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "SUITE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-553-2252",
            "fax_number": "205-553-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "SUITE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-553-2252",
            "fax_number": "205-553-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISHUCK",
        "first_name": "JOHN",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "AL",
            "license": "12867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ALABAMA",
            "identifier": "51083745",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83745",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.