Peter F Demitry, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

0101042345 Issued in VA

Practice address

3700 Drake LN
Haymarket, VA 20169-2477

Phone

(703) 678-9888

Fax

(480) 772-4072

NPI assigned

Jun 22, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1649407222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 DRAKE LN",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201692477",
            "telephone_number": "703-678-9888",
            "fax_number": "480-772-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 DRAKE LN",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201692477",
            "telephone_number": "703-678-9888",
            "fax_number": "480-772-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMITRY",
        "first_name": "PETER",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "VA",
            "license": "0101042345",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "VA",
            "license": "0101042345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James P Craft III
• Rupinder K Dadwal
• David R. Gore, O.D. P.C.
• Lorin Christopher Davies, LPC
• Malikah Hafeeza Day, PHARM D.
• Dentists Shoppes of Haymarket PC
• Tejal Dharia, M.D.
• Tiffany Dibenedetto, LCSW
• Dominion Craftsman Services,LLC
• Dominion Lifestyle Serivces, LLC

• Occupational Medicine Physician in Haymarket, VA
• Providers in Haymarket, VA by specialty
• Occupational Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.