Joshua P Dietzer, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

66479 Issued in GA

Practice address

3131 S Main St
Emergency Department
Moultrie, GA 31768-6925

Phone

(850) 391-1752

Fax

(850) 273-6357

NPI assigned

Apr 29, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

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 2

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franklin County Board of County CommissionersGroup PAC ID 3274541115, 29 clinicians

Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Emergency Group of Columbus LLCGroup PAC ID 2668735515, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064
• Tampa General Hospital Crystal River Hospital, Crystal River, FL, CCN 100249

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: jdietzer295984@direct.tgh.org

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.

• Emergency Group of Columbus, LLC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1316458227

  Emergency Medicine, GA

  Medicare reassignment Care Compare group NPD
• Franklin County Board of County Commissioners

  • Critical Access Hospital
  • Apalachicola, FL
  • NPI 1790736767

  FL

  Medicare reassignment Care Compare group NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650

  Emergency Medicine, FL

  Medicare reassignment Care Compare group NPD
• Colquitt Regional Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Moultrie, GA
  • NPI 1902211642

  Emergency Medicine, GA

  Medicare reassignment NPD
• Heritage Physician Services, LLC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1003321969

  Emergency Medicine, GA

  Medicare reassignment NPD
• Southland EMS at Weems PL

  • Emergency Medicine Physician
  • Apalachicola, FL
  • NPI 1124302443

  Emergency Medicine, FL

  Medicare reassignment NPD
• Southland Hospitalist at Weems PL

  • Emergency Medicine Physician
  • Apalachicola, FL
  • NPI 1801170113

  Emergency Medicine, FL

  Medicare reassignment NPD
• W4P LLC

  • Emergency Medicine Physician
  • Spring Hill, FL
  • NPI 1689116618

  Emergency Medicine, FL

  Medicare reassignment NPD
• Franklin County Board of County Commissioners

  • Rural Health Clinic/Center
  • Carrabelle, FL
  • NPI 1033438627
  Care Compare group
• Franklin County Board of County Commissioners

  • Ambulance
  • Apalachicola, FL
  • NPI 1386784940
  Care Compare group
• Franklin County Board of County Commissioners

  • Rural Health Clinic/Center
  • Apalachicola, FL
  • NPI 1649516899
  Care Compare group
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

• The Medical Center Inc

  • General Acute Care Hospital
  • Columbus, GA
  • NPI 1255401519

  Hospital

  Care Compare affiliation
• Tampa General Hospital Citrus LLC

  • General Acute Care Hospital
  • Crystal River, FL
  • NPI 1407637531

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1306080759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 90TH AVE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337824709",
            "telephone_number": "850-391-1752",
            "fax_number": "850-273-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 S MAIN ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686925",
            "telephone_number": "850-391-1752",
            "fax_number": "850-273-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZER",
        "first_name": "JOSHUA",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "66479",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME107771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethia Dawson-Reese, PHARMD
• Michael J Dawson Jr., M.D.
• Daniel L Dell, CRNA
• Isha Denegall
• Stephanie Diers, NP
• Heather G Dismuke, FNP-BC
• Daniel Rustin Dixon
• Woodly Terry Dominique
• Jaclyn Kaylor Donovan, MBA, MS, ATC, LAT
• Laura Lee Durham, CCC/SLP

• All providers in Moultrie, GA
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.