Diabetes, Endocrinology & Lipidology Center, Inc.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

21393 Issued in WV

Legal business name

DIABETES, ENDOCRINOLOGY & LIPIDOLOGY CENTER, INC.

Practice address

176 Health Care LN
Suite B
Martinsburg, WV 25401-4010

Phone

(304) 260-1060

Fax

(304) 260-1062

NPI assigned

Nov 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Philip Joseph Ryan, M.D.NPI 1043396229

Title

President

Phone

(304) 260-1060

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip J a Ryan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Martinsburg, WV
  • NPI 1043396229
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1275810830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 HEALTH CARE LN",
            "address_2": "SUITE B",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254014010",
            "telephone_number": "304-260-1060",
            "fax_number": "304-260-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 HEALTH CARE LN",
            "address_2": "SUITE B",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254014010",
            "telephone_number": "304-260-1060",
            "fax_number": "304-260-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES, ENDOCRINOLOGY & LIPIDOLOGY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-10",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-260-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WV",
            "license": "21393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022262",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dept of Veteran Affairs
• Cathryn Mary Deronda, MSW, LGSW
• Tammy Sue Detweiler
• David Benjamin Deuell, D.O.
• Sandra Devonshire
• Gnima Diaw, PMHNP
• Alfred Diaz, BA
• Stacey Diaz
• Jennifer Dick
• Karissa Dicken, RN

• Endocrinology, Diabetes & Metabolism Physician in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Endocrinology, Diabetes & Metabolism Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.