Active NPI
Dino Anthony Desantis, ACNP-BC
- Acute Care Nurse Practitioner
- Nashville, TN
National Provider Identifier
1326224809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 13167
- Practice address
- 1310 24TH Ave S
VA Tennessee Valley Healthcare System
Nashville, TN 37212-2637 - Phone
- (615) 873-7512
- Fax
- (615) 873-7757
- NPI assigned
- Jan 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6075P | KY | |
| Acute Care Nurse Practitioner | 363LA2100X | 13167 | TN | Primary |
Addresses
Primary practice location
1310 24TH Ave S
VA Tennessee Valley Healthcare System
Nashville, TN 37212-2637
Mailing address
1310 24TH Ave S
VA Tennessee Valley Healthcare System
Nashville, TN 37212-2637
Phone (615) 873-7512
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000028412Q | Other | KY | HUMANA |
| 000000622722 | Other | KY | ANTHEM |
| 200966480 | Medicaid | IN | |
| 3744147000 | Other | KY | PASSPORT ADVANTAGE |
| 9038116 | Other | KY | CIGNA |
| 7100088140 | Medicaid | KY | |
| 106553 | Other | KY | SIHO |
| 50026174 | Other | KY | PASSPORT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13167 | TN | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1326224809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 24TH AVE S",
"address_2": "VA TENNESSEE VALLEY HEALTHCARE SYSTEM",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372122637",
"telephone_number": "615-873-7512",
"fax_number": "615-873-7757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 24TH AVE S",
"address_2": "VA TENNESSEE VALLEY HEALTHCARE SYSTEM",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372122637",
"telephone_number": "615-873-7512",
"fax_number": "615-873-7757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANTIS",
"first_name": "DINO",
"middle_name": "ANTHONY",
"credential": "ACNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-15",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "6075P",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TN",
"license": "13167",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "000028412Q",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000622722",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200966480",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT ADVANTAGE",
"identifier": "3744147000",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9038116",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100088140",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIHO",
"identifier": "106553",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "50026174",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.