Anne Ellsworth Dantzler, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

44539 Issued in MA

Practice address

940 Belmont St, BLDG 2, 3Rd Floor, Ward 2-3-B Or A310
VA Boston Healthcare System, Brockton Division
Brockton, MA 02301-5596

Phone

(774) 826-1408

Fax

(774) 826-3217

NPI assigned

Oct 10, 2006

Last updated

Aug 9, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1801984349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HAMMOND POND PKWY",
            "address_2": "410N",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671545",
            "telephone_number": "617-699-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST, BLDG 2, 3RD FLOOR, WARD 2-3-B OR A310",
            "address_2": "VA BOSTON HEALTHCARE SYSTEM, BROCKTON DIVISION",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-1408",
            "fax_number": "774-826-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "ANNE",
        "middle_name": "ELLSWORTH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "MA",
            "license": "44539",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "44539",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MA",
            "license": "44539",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "J16409",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Astrid Damas
• Erica Christine Damiano, COTA/L
• Ruinide Danger-Alexis, MA
• Gabriella Daniel
• Anna Daniels
• Amrosieta Danwah-Mor
• Darryll Darant
• Lourdy Darcisse Adrien
• Jessica Lee Darcy
• Sarah White Darling, PSY.D.

• Psychiatry Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.