Individual provider Active NPI

Dean V Dimotsis, D.P.M.

  • Podiatrist
  • Waynesboro, VA
National Provider Identifier
1760426357
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103000371 Issued in VA
Practice address
15 Pratts Run
#105
Waynesboro, VA 22980-6606
Phone
(540) 946-9177
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103000371 VA Primary

Addresses

Primary practice location

15 Pratts Run
#105
Waynesboro, VA 22980-6606

Mailing address

15 Pratts Run
#105
Waynesboro, VA 22980-6606
Phone (540) 946-9177

Other identifiers 12

IdentifierTypeStateIssuer
1336330620MedicaidVA
1588847982OtherVANPI GROUP LEXINGTON
1336330620OtherVAVIRGINIA PREMIER
1336330620OtherVAVIRGINIA HEALTH NETWORK
1336330620OtherVASOUTHERN HEALTH
283489OtherVAANTHEM
1336330620OtherGROUP NPI
1760426357OtherVANPI
C10346OtherVAMEDICARE GROUP PIN
035371OtherVAANTHEM
P00444410OtherVARAILROAD MEDICARE PIN
DG6187OtherVARAILROAD MEDICARE GROUP

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0103000371VAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Podiatry Associates Podiatrist Past Accepting new patients
Blue Ridge Footcare and Surgery PLC Podiatrist PastSince Oct 22, 2007 Accepting new patients
Blue Ridge Footcare and Surgery PLC Podiatrist PastSince Oct 1, 2007 Accepting new patients
Foot and Ankle Center Podiatrist Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1760426357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PRATTS RUN",
            "address_2": "#105",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229806606",
            "telephone_number": "540-946-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PRATTS RUN",
            "address_2": "#105",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229806606",
            "telephone_number": "540-946-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMOTSIS",
        "first_name": "DEAN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336330620",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP LEXINGTON",
            "identifier": "1588847982",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "1336330620",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "1336330620",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "1336330620",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "283489",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1336330620",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760426357",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "C10346",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "035371",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00444410",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DG6187",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.