Individual provider Active NPI

Anne C Dibala, MD

  • Psychiatry Physician
  • Lebanon, VA
National Provider Identifier
1487614301
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101047498 Issued in VA
Practice address
71 S Flannagan Avenue
Lebanon, VA 24266
Phone
(276) 883-8042
Fax
(276) 883-8044
NPI assigned
Mar 24, 2006
Last updated
Feb 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 13214 SC
Psychiatry Physician 2084P0800X 0101047498 VA Primary

Addresses

Primary practice location

71 S Flannagan Avenue
Lebanon, VA 24266

Mailing address

71 S Flannagan Avenue
Lebanon, VA 24266
Phone (276) 883-8042

Other identifiers 6

IdentifierTypeStateIssuer
1487614301MedicaidVA
327877MedicaidSC
405127MedicaidSC
132145MedicaidSC
P01414635OtherVARAILROAD MEDICARE
534147000OtherVAMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110314000930 VA Practitioner - Psychiatry 3971539644 Reassigns benefits to 1 organization
I20170426001771 WI Practitioner - Psychiatry 3971539644 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13214SCMDClinical Social Worker
0101047498VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Amery Regional Medical Center, Inc. Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
Cannon Psychological Associates, PC PastSince Jul 24, 2022 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
Southeastern Regional Mental Health Center Past Accepting new patients
Gregory S. Smith & Associates, P.a. PastSince Jun 27, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: annedibala@tdh.allscriptsdirect.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1487614301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 S FLANNAGAN AVENUE",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-883-8042",
            "fax_number": "276-883-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 S FLANNAGAN AVENUE",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-883-8042",
            "fax_number": "276-883-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBALA",
        "first_name": "ANNE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "13214",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101047498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487614301",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327877",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405127",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132145",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01414635",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "534147000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, VA

Sources for this page

Verify at the official NPI Registry.