Active NPI
Reno Jackson Dykes, MD
- Psychiatry Physician
- Manassas, VA
National Provider Identifier
1356468102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101022041
- Practice address
- 7969 Ashton Ave
Manassas, VA 20109-2885 - Phone
- (703) 792-7800
- Fax
- (703) 792-5699
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101022041 | VA | Primary |
Addresses
Primary practice location
7969 Ashton Ave
Manassas, VA 20109-2885
Mailing address
7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4945247 | Medicaid | VA | |
| 235344 | Other | VA | BLUE CROSS BLUE SHIELD |
| 294394 | Other | VA | AMERIGROUP |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101022041 | VA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prince William County | Past | Accepting new patients | |
| Prince William County Community Services Board | 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 and National Provider Directory roles.
-
- Ambulance
- Prince William, VA
- NPI 1235437385
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Manassas, VA
- NPI 1053402800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356468102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7969 ASHTON AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092885",
"telephone_number": "703-792-7800",
"fax_number": "703-792-5699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7969 ASHTON AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092885",
"telephone_number": "703-792-7800",
"fax_number": "703-792-5699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKES",
"first_name": "RENO",
"middle_name": "JACKSON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101022041",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4945247",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "235344",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "294394",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.