Marie Veronica Dethomas, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95002884 Issued in CA

Practice address

10399 Lemon Ave Ste 101
Rancho Cucamonga, CA 91737-3771

Phone

(909) 466-7337

NPI assigned

Jan 3, 2016

Sex

Female

Sole proprietor

No

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: marie.dethomas.1@25094.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/9243/brand/1/csg/1/fhir/r4

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.

• Advanced Diagnostic Imaging, PC

  dba AdvancedHealth

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464
  NPD (past)
• Privia Medical Group Tennessee LLC

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1376110858
  NPD (past)

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

{
    "created_epoch": "1451779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451779200000",
    "number": "1811353196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12931 EVERMAY CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399244",
            "telephone_number": "909-261-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10399 LEMON AVE STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373771",
            "telephone_number": "909-466-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETHOMAS",
        "first_name": "MARIE",
        "middle_name": "VERONICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-03",
        "last_updated": "2016-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95002884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manisha S Desai, DDS
• Riya Desai
• Brandi Lonje Deshannon
• James Phillip Desilva
• Eden D Desta
• Meredith Dettmar, P.A.-C
• Christopher Robin Deulen, PH.D
• Devine Counseling
• Elizabeth Dewitt
• Sharon Dey-Layne, CNS

• Pediatric Nurse Practitioner in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2016; 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.