Guy Andrew Dietels, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

061800456 Issued in VA

Practice address

1455 Towne Square Blvd NW
Roanoke, VA 24012-1612

Phone

(540) 265-0595

Fax

(540) 265-0596

NPI assigned

May 10, 2006

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 4

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 1986

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1902855414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BITTERSWEET LN",
            "city": "HARDY",
            "state": "VA",
            "postal_code": "241013333",
            "telephone_number": "540-427-0567",
            "fax_number": "540-427-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 TOWNE SQUARE BLVD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240121612",
            "telephone_number": "540-265-0595",
            "fax_number": "540-265-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETELS",
        "first_name": "GUY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "061800456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA PROVIDER #",
            "identifier": "487193",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009230645",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER #",
            "identifier": "224243",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA  PROVIDER #",
            "identifier": "5709659",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ania Dickenson, BSN
• Shelby C Dickerson, MD
• Floyd Randolph Dickey, DDS
• Heather B Dickey, AU.D.
• Michelle Diehl, LPC
• Nicholas Paul Digiovanni, L.P.T.A., C.S.C.S.
• Skylar Mackenzie Digou
• Joe Dill
• Hannah Dillard
• Traketa La'Shawn Dillard, LPC

• Corneal and Contact Management Optometrist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Corneal and Contact Management Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.