Dustin J Ditmore

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT-28915 Issued in AZ

Practice address

15170 N Hayden Rd Ste 6B
Scottsdale, AZ 85260-2571

Phone

(602) 805-4877

NPI assigned

Jan 10, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Coyote Bodywork

  • Massage Therapist
  • Scottsdale, AZ
  • NPI 1386326171
  NPD

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1790556520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15170 N HAYDEN RD STE 6B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602571",
            "telephone_number": "602-805-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15170 N HAYDEN RD STE 6B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602571",
            "telephone_number": "602-805-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITMORE",
        "first_name": "DUSTIN",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-28915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Discovery and Wellness PLLC (Discovery & Wellness Counseling)
• Micale Renae Dishong, NP
• Ann Bouvier Disilvestro, O.T.R. L
• Kathryn Distel, RN
• Ditare, Inc (Therapy Rehabilitation Services, Inc)
• Natalie Ditullio, LCSW
• Diversified Medical Solutions
• Ronald W Divine, MD
• Enrico E. Divito, D.D.S., P.C.
• Roberto E Divito, DDS

• Massage Therapist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.