NPIMap

Individual provider Active NPI

Bocar Dieng

  • Intellectual & Developmental Disabilities Psychologist
  • Blacklick, OH
National Provider Identifier
1598214165
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
UK685720 Issued in OH
Practice address
131 Heatherbridge LN
Blacklick, OH 43004-9269
Phone
(404) 803-7080
NPI assigned
Sep 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X UK685720 OH
Intellectual & Developmental Disabilities Psychologist 103TM1800X UK685720 OH Primary

Addresses

Primary practice location

131 Heatherbridge LN
Blacklick, OH 43004-9269

Mailing address

131 Heatherbridge LN
Blacklick, OH 43004-9269
Phone (404) 803-7080

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

State licenses

LicenseStateTypeSpecialty
UK685720OHMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Duty Health Care Services, LLC Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1598214165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HEATHERBRIDGE LN",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430049269",
            "telephone_number": "404-803-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 HEATHERBRIDGE LN",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430049269",
            "telephone_number": "404-803-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIENG",
        "first_name": "BOCAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "UK685720",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "OH",
            "license": "UK685720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacklick, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.