Individual provider Active NPI

Dyan Jenelle Harvey-Dent, D.O.

  • Family Medicine Physician
  • Valrico, FL
National Provider Identifier
1245263813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS8642 Issued in FL
Practice address
4325 Lynx Paw TRL
Valrico, FL 33594-7426
Phone
(813) 684-9600
Fax
(813) 662-9777
NPI assigned
Jul 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS8642 FL Primary

Addresses

Primary practice location

4325 Lynx Paw TRL
Valrico, FL 33594-7426

Mailing address

4325 Lynx Paw TRL
Valrico, FL 33594-7426
Phone (813) 684-9600

Other identifiers 1

IdentifierTypeStateIssuer
271359400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140214001479 FL Practitioner - Family PracticePractitioner - Dermatology 5294719985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Dermatology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4325 Lynx Paw Trail
Valrico, FL 33596-7426

4325 Lynx Paw TRL
Valrico, FL 33596-7426

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS8642FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert a. Norman, D.O., P.a. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245263813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LYNX PAW TRL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335947426",
            "telephone_number": "813-684-9600",
            "fax_number": "813-662-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 LYNX PAW TRL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335947426",
            "telephone_number": "813-684-9600",
            "fax_number": "813-662-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY-DENT",
        "first_name": "DYAN",
        "middle_name": "JENELLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271359400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.