John Duffy Dewalt, D.O.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

34002686D Issued in OH

Practice address

144 East Main Street
Logan, OH 43138

Phone

(740) 385-1881

Fax

(740) 385-1875

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Merit-based Incentive Payment System (MIPS)

Final score

79.44 of 100Reported as group

Quality

75.57

Promoting interoperability

79

Improvement activities

40

Cost

73.41

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984
  Medicare reassignment NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD
• Regional Employee Assistance Program Inc

  • Internal Medicine Physician
  • Victoria, TX
  • NPI 1215999511
  NPD
• Fairfield Healthcare Professionals Inc

  • Surgery Physician
  • Lancaster, OH
  • NPI 1093730681
  NPD (past)
• Fairfield Healthcare Professionals Inc

  • Psychiatry Physician
  • Lancaster, OH
  • NPI 1255372215
  NPD (past)
• Fairfield Healthcare Professionals, Inc.

  • Family Medicine Physician
  • Baltimore, OH
  • NPI 1174579791
  NPD (past)
• Hocking Valley Medical Group Transportation

  • Non-emergency Medical Transport (VAN)
  • Logan, OH
  • NPI 1417555087
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1508869702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 E MAIN ST",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "43138",
            "telephone_number": "740-385-1881",
            "fax_number": "740-385-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 EAST MAIN STREET",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "43138",
            "telephone_number": "740-385-1881",
            "fax_number": "740-385-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALT",
        "first_name": "JOHN",
        "middle_name": "DUFFY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "34002686D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC PROVIDER NUMBER",
            "identifier": "1269034",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CD3781",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0365073",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen Marie Del Valle, RPH
• Teresa S. Dement, LPCC, LICDC
• Ashley Demoss, DENTAL ASST.
• Cathy Sue Dennison, LPN
• Nicholas Devol
• Diles Logan Hearing Center, L.L.C.
• Stacy Dingess
• Tiffany N Dolin, CDCA
• Stacy Lynn Donaldson, STNA
• Lorie A Downour, LMT

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Logan, OH
• Providers in Logan, OH by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.