Anna Ellesor Gray Detweiler, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

Practice address

6320 N Center Dr
BLDG 15 Suite 201
Norfolk, VA 23502-4009

Phone

(757) 892-5300

Fax

(757) 892-5303

NPI assigned

Dec 2, 2013

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Coastal Prosthetics & Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Norfolk, VA
  • NPI 1558328393
  NPD (past)

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1356772305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 N CENTER DR",
            "address_2": "BLDG 15 SUITE 201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024009",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 N CENTER DR",
            "address_2": "BLDG 15 SUITE 201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024009",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWEILER",
        "first_name": "ANNA",
        "middle_name": "ELLESOR GRAY",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepak Deshmukh, D.O.
• Marc Carleton Desolminihac, MD
• Destiny Home Health Care, LLC
• Jennie Rebecca Desy, M.S., CCC-A
• Detriot Health Supplies
• Chelsea Rose Deuel, ACNP
• Brian Deutsch, M.D.
• Stephen Irwin Deutsch, M.D.
• Rebecca Marie Deuvall, PHARM.D.
• Sudipta Devanath, MD

• Prosthetist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Prosthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.