Dennis W. Dietrich, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

5223 Issued in MT

Practice address

400 15TH Ave S
Ste 206
Great Falls, MT 59405-4375

Phone

(406) 727-3720

Fax

(406) 727-0007

NPI assigned

Oct 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MT

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871677245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 15TH AVE S",
            "address_2": "STE 206",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054375",
            "telephone_number": "406-727-3720",
            "fax_number": "406-727-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 15TH AVE S",
            "address_2": "STE 206",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054375",
            "telephone_number": "406-727-3720",
            "fax_number": "406-727-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "DENNIS",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MT",
            "license": "5223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075036",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Faye Devine, FNP
• Elliot John Dewit, CPO
• Saugat Dey, M.D.
• Jeramy Gerard Dickman, LAC
• Heath Rulin Diel, MD
• Kathleen M Diller, MD
• Mavis Dillman
• Angelia Marie Disalvo
• Discount Pharmacy Inc (Discount Pharmacy)
• Discount Pharmacy Inc.

• Neurology Physician in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Neurology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.