Jack Foster Ditty Jr., M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

20687 Issued in KY

Practice address

100 Saint Christopher Dr
Ashland, KY 41101-7016

Phone

(606) 836-3111

Fax

(606) 833-5660

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in KY

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

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jack F. Ditty, MD, PSC

  • Dermatology Physician
  • Ashland, KY
  • NPI 1386999787
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1740315589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAINT CHRISTOPHER DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017016",
            "telephone_number": "606-836-3111",
            "fax_number": "606-833-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAINT CHRISTOPHER DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017016",
            "telephone_number": "606-836-3111",
            "fax_number": "606-833-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTY",
        "first_name": "JACK",
        "middle_name": "FOSTER",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "20687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "611053554",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64206873",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024 1170",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER #",
            "identifier": "000000048343",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20687",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Duayne Dillon, DC
• Jolinda R Dillow, M.D.
• Margie Dillow, LCSW
• Brooke Anna Dingess, CRNA
• Dean Dippolito, LPCC
• Diversicare Leasing Corp.
• Grace Ann Dixon, M.D.
• Justin Kevin Dixon, M.D.
• Timothy K Dixon, MD
• Stephen Dockins, DO

• MOHS-Micrographic Surgery Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• MOHS-Micrographic Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.