Active NPI
Roxanne Dietzler, DO
- Family Medicine Physician
- Newport News, VA
National Provider Identifier
1407928872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0102049994
- Practice address
- 732 Thimble Shoals Blvd
Ste 102
Newport News, VA 23606 - Phone
- (757) 599-3623
- Fax
- (757) 599-1819
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0102049994 | VA | Primary |
Addresses
Primary practice location
732 Thimble Shoals Blvd
Ste 102
Newport News, VA 23606
Mailing address
215 Hilton Terrace
Newport News, VA 23601
Phone (757) 596-5605
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102049994 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Immaculate Hospital LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Newport News, VA
- NPI 1538535463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407928872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 HILTON TERRACE",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "23601",
"telephone_number": "757-596-5605",
"fax_number": "757-596-5605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 THIMBLE SHOALS BLVD",
"address_2": "STE 102",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "23606",
"telephone_number": "757-599-3623",
"fax_number": "757-599-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZLER",
"first_name": "ROXANNE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0102049994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport News, 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.