Active NPI
John William Demetree, MD
- Dermatology Physician
- Bradenton, FL
National Provider Identifier
1962474437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- ME0033525
- Practice address
- 1312 Riverview Cir
Bradenton, FL 34209-1257 - Phone
- (941) 792-2007
- Fax
- (941) 792-2007
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | ME0033525 | FL | Primary |
Addresses
Primary practice location
1312 Riverview Cir
Bradenton, FL 34209-1257
Mailing address
1312 Riverview Cir
Bradenton, FL 34209-1257
Phone (941) 792-2007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406073299 | Other | FL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0033525 | FL | MD | Dermatology Physician |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1962474437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 RIVERVIEW CIR",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342091257",
"telephone_number": "941-792-2007",
"fax_number": "941-792-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 RIVERVIEW CIR",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342091257",
"telephone_number": "941-792-2007",
"fax_number": "941-792-2007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMETREE",
"first_name": "JOHN",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME0033525",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "406073299",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.