Walter Dietzgen, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

37818 Issued in NC

Practice address

5041 New Centre Dr.
Suite 200
Wilmington, NC 28403-1624

Phone

(910) 313-3232

NPI assigned

Sep 22, 2006

Last updated

Sep 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Albemarle Mental Health Center

  • Mental Health Counselor
  • Elizabeth City, NC
  • NPI 1013012400
  NPD (past)
• Coastalcare

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1316006075
  NPD (past)
• Behavioral Healthcare Services, Inc.

  dba New Mexico Solutions

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1255780037
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1548369994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 NEW CENTRE DR.",
            "address_2": "SUITE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031624",
            "telephone_number": "910-313-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 NEW CENTRE DR.",
            "address_2": "SUITE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031624",
            "telephone_number": "910-313-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZGEN",
        "first_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "37818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Stewart McLendon Dickson, PA-C
• Sonya Didomenico-Young, DC
• Benjamin Diehl
• Sarah Dietz, PSYD
• Magdalena Mulhall Dietzgen, PT
• Mandy L Difelice
• Alyssa Bertolino Diggan, OTR/L
• Brianna Florence Digilio, M.A., BCBA
• Sasha Coefield Digiovanni, RD
• Donald A Digiulian, DDS

• Psychiatry Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.