NPIMap

Individual provider Active NPI

David Joseph Dibble, D.O.

  • Emergency Medicine Physician
  • Bolivia, NC
National Provider Identifier
1710025341
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2007-00648 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(910) 721-1000
Fax
(910) 754-2032
NPI assigned
Feb 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2007-00648 NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

PO Box 3439
North Myrtle Beach, SC 29582-0439
Phone (843) 839-4447

Other identifiers 3

IdentifierTypeStateIssuer
Q0064LMedicaidSC
2007-00648OtherNCMEDICAL LICENSE
5907240MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070821000262 NC Practitioner - Emergency Medicine 3173615267 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarheel Emergency Group, PLLCGroup PAC ID 6709268576, 40 clinicians

Practice addresses (Care Compare)

317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345

Hospital & facility affiliations

  • Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Dec 24, 2020 Accepting new patients
Tarheel Emergency Group, PLLC Emergency Medicine CurrentSince Aug 15, 2022 Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Apr 9, 2018 Accepting new patients
Brunswick Physician Partners, PLLC Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Emergency Medicine Physicians of Craven County, PLLC Emergency Medicine CurrentSince Dec 9, 2019 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Kinston Physicians Group, PLLC Emergency Medicine CurrentSince Oct 15, 2019 Accepting new patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Brunswick Community Hospital, LLC PastSince Oct 13, 2024 Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

100 Airport Rd
Kinston, NC 28501
Phone (252) 522-7000

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1710025341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295820439",
            "telephone_number": "843-839-4447",
            "fax_number": "843-399-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-721-1000",
            "fax_number": "910-754-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2007-00648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0064L",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "2007-00648",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907240",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.