Individual provider Active NPI

Jamie Lauren Dermatis, DPM

  • Student in an Organized Health Care Education/Training Program
  • Virginia Beach, VA
National Provider Identifier
1629496633
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1700 Pleasure Road
#101
Virginia Beach, VA 23455
Phone
(757) 363-3338
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0103301234 VA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1700 Pleasure Road
#101
Virginia Beach, VA 23455

Mailing address

2401 Locksley Arch
Virginia Beach, VA 23456-6998
Phone (410) 487-4844

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0103301234VAMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1629496633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 LOCKSLEY ARCH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234566998",
            "telephone_number": "410-487-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PLEASURE ROAD",
            "address_2": "#101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23455",
            "telephone_number": "757-363-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMATIS",
        "first_name": "JAMIE",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103301234",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.