Individual provider Active NPI

Demetrius S. Maoury, M.D.

  • Internal Medicine Physician
  • Warrenton, VA
National Provider Identifier
1619941796
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101054103 Issued in VA
Practice address
419 Holiday Court
Suite 100
Warrenton, VA 20186
Phone
(540) 347-4200
Fax
(540) 341-7054
NPI assigned
Feb 15, 2006
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101054103 VA Primary

Addresses

Primary practice location

419 Holiday Court
Suite 100
Warrenton, VA 20186

Mailing address

419 Holiday Court
Suite 100
Warrenton, VA 20186
Phone (540) 347-4200

Other identifiers 1

IdentifierTypeStateIssuer
010026121MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20031209001019 VA Practitioner - Internal Medicine 8325944754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Virginia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fauquier Physician Practices LLCGroup PAC ID 6406083104, 43 clinicians

Practice addresses (Care Compare)

419 Holiday CT
Suite 100
Warrenton, VA 20186-4371
Phone (540) 347-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fauquier Physician Practices LLC Internal Medicine CurrentSince Nov 1, 2014 Accepting new patients
Piedmont Internal Medicine PLC Internal Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

419 Holiday Ct
Ste 100
Warrenton, VA 20186
Phone (540) 347-4200

493 Blackwell Rd
Ste 201
Warrenton, VA 20186
Phone (540) 341-1710

550 Hospital Dr
Warrenton, VA 20186
Phone (540) 316-5940

614 Hastings Ln
Warrenton, VA 20186
Phone (540) 347-4770

Interoperability endpoints

  • Direct secure messaging: demetrius.maoury.1@16767.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1619941796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 HOLIDAY COURT",
            "address_2": "SUITE 100",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "20186",
            "telephone_number": "540-347-4200",
            "fax_number": "540-341-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 HOLIDAY COURT",
            "address_2": "SUITE 100",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "20186",
            "telephone_number": "540-347-4200",
            "fax_number": "540-341-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAOURY",
        "first_name": "DEMETRIUS",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101054103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010026121",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.