Darius Jose Ayala Divina, DO
Individual provider Active NPI Orthopaedic Surgery Physician · Louisburg, NC
NPI 1366544843 · NPPES record last updated Sep 22, 2022
Key facts
- NPI
- 1366544843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 2018-02770 (NC)
- Practice address
- 1501 N Bickett Blvd Ste E
Louisburg, NC 27549-2178 - Phone
- (919) 497-8380
- Fax
- (919) 497-8385
- NPI assigned
- Sep 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Michigan State University College of Osteopathic Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DLP Maria Parham Physician Practices LLC
Carolina Physical Therapy Associates LLC
Practice addresses (Care Compare)
120 Charles Rollins Rd
Henderson, NC 27536-2882
1501 N Bickett Blvd
Louisburg, NC 27549-2178
Phone (919) 497-8414
205 Sandalwood Ave
Suite B
Louisburg, NC 27549-2679
Phone (919) 340-7010
566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone (252) 436-1148
Hospital & facility affiliations
- Centerwell Home Health
- Maria Parham Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Knee replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181204000354 | NC | Practitioner - Orthopedic Surgery | 3678521879 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Maria Parham Physician Practices, LLC | Current | Accepting new patients | |
| DLP Person Physician Practices LLC | Orthopaedic Surgery | Current |
Accepting new patients |
| DLP Person Physician Practices, LLC | Current | Accepting new patients | |
| DLP Maria Parham Physician Practices, LLC | Current |
Accepting new patients | |
| DLP Maria Parham Physician Practices LLC | Current |
Accepting new patients | |
| Bayside Allergy, P.C. | Past | Accepting new patients |
Locations
120 Charles Rollins Rd
Ste 102
Henderson, NC 27536
Phone (252) 436-0440
120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773
1501 N Bickett Blvd
Ste E
Louisburg, NC 27549
Phone (919) 497-0445
205 Sandalwood Ave
Ste B
Louisburg, NC 27549
Phone (919) 340-7010
601 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Interoperability endpoints
- darius.divina.1@20247.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 1135 | SC | |
| Orthopaedic Surgery Physician | 207X00000X | 2018-02770 | NC | Yes |
Addresses
Primary practice location
1501 N Bickett Blvd Ste E
Louisburg, NC 27549-2178
Mailing address
1501 N Bickett Blvd Ste E
Louisburg, NC 27549-2178
Phone (919) 497-8380
Other practice location 1
901 W Greenwood St Ste 8B
Abbeville, SC 29620-5717
Phone (864) 366-6060
Other practice location 2
2000 E Greenville St
Suite 2550
Anderson, SC 29621-1580
Phone (864) 716-6140
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3255 | Other | SC | MEDICARE PTAN FOR ABBEVILLE OFFICE |
| 011356 | Medicaid | SC | |
| 1366544843 | Medicaid | NC |
Other providers in Louisburg, NC
- Rieann Davina Dantzler
- Cassandra Davis
- Saniece L Davis
- Allison Kathryn Dgien
- Gemma Diez-Belano
- Divine Family Care Home
- Divine Family Care Home Inc.
- DLP Maria Parham Medical Center LLC
- DLP Maria Parham Physician Practices LLC
- DLP Maria Parham Physician Practices LLC
All providers in Louisburg, NC · Orthopaedic Surgery Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.