John Mark Dimichele, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2015-02134 Issued in NC

Practice address

1141 N Road St
Elizabeth City, NC 27909-3354

Phone

(252) 384-2590

Fax

(252) 384-2589

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdimichele410395@direct.ecuhealth.com

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.

• Outer Banks Professional Services, LLC

  • Multi-Specialty Clinic/Center
  • Nags Head, NC
  • NPI 1891050357
  Medicare reassignment NPD
• Albemarle Physician Services - Sentara, Inc

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1942443130

  NC, Pediatrics

  Medicare reassignment NPD
• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1871621680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093354",
            "telephone_number": "252-384-2590",
            "fax_number": "252-384-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N ROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093354",
            "telephone_number": "252-384-2590",
            "fax_number": "252-384-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMICHELE",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "VT",
            "license": "0420009297",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2015-02134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28911",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1356",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Frances Derrick
• Serena Desocio, RBT
• Govind Dhakal, MD
• Diabetes Thyroid & Endocrinology
• Karina Julia Dick, DDS
• Discovering Hope
• Britney Lorene Dixon, MS, LCMHC, LPC
• Doctor G Family Medical Services
• Barbara Doleshal, MD
• Margaret Rose Donohoe, MD

• Pediatrics Physician in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.