Vinson Michael Disanto, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO0000001488 Issued in TN

Practice address

10725 Bald Cypress LN
Knoxville, TN 37922-6760

Phone

(609) 760-8766

NPI assigned

May 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 29, 2014 through May 29, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• St. Mary's Health, Inc

  dba Ascension St. Vincent Evansville

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1932300134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MAJESTIC WAY",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533774",
            "telephone_number": "732-542-2638",
            "fax_number": "732-542-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10725 BALD CYPRESS LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379226760",
            "telephone_number": "609-760-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Monmouth Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "West Long Branch",
            "state": "NJ",
            "postal_code": "077641000",
            "country_code": "US",
            "telephone_number": "732-542-2638",
            "fax_number": "732-542-2620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISANTO",
        "first_name": "VINSON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5627",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "25MB07769000",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "DO0000001488",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO0000001488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice C Dingus, RN
• John Porter Dinsmore, DDS
• Richard Raymond Dion, LPC
• Maureen Diroma
• Disability Resource Center
• Discover Speech Therapy, LLC
• Whitney Paige Disney, COTA/L
• Andrew Dean Dison, B.A.
• Dispatchhealth-Idaho PC (DispatchHealth)
• Emily Distasio

• Family Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.