Active NPI
John Brian Dilley, ED.D.
- Clinical Psychologist
- Des Moines, IA
National Provider Identifier
1972647626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 376
- Practice address
- 1350 NW 138TH St
Suite 200
Des Moines, IA 50325-8377 - Phone
- (515) 223-4188
- Fax
- (515) 223-9570
- NPI assigned
- Feb 16, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 376 | IA | Primary |
Addresses
Primary practice location
1350 NW 138TH St
Suite 200
Des Moines, IA 50325-8377
Mailing address
1350 NW 138TH St
Suite 200
Des Moines, IA 50325-8377
Phone (515) 223-4188
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1229 | Other | IA | PROF. MOBILITY (ASPPB) |
| 376 | Other | IA | PSYCHOLOGIST |
| 123 | Other | IA | HEALTH SERVICE PROVIDER |
Other names 1
- Dr. John B. Dilley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041220001108 | IA | Practitioner - Clinical Psychologist | 8022076264 | Practice locations: Panora, IA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
7049 Andrews Ter
Panora, IA 50216-8705
Phone (515) 238-1602
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 376 | IA | MD | Clinical Psychologist |
| 00376 | IA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972647626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 NW 138TH ST",
"address_2": "SUITE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503258377",
"telephone_number": "515-223-4188",
"fax_number": "515-223-9570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 NW 138TH ST",
"address_2": "SUITE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503258377",
"telephone_number": "515-223-4188",
"fax_number": "515-223-9570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLEY",
"first_name": "JOHN",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IA",
"license": "376",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROF. MOBILITY (ASPPB)",
"identifier": "1229",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST",
"identifier": "376",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH SERVICE PROVIDER",
"identifier": "123",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOHN",
"last_name": "DILLEY",
"middle_name": "B.",
"prefix": "DR.",
"credential": "P.L.C.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Des Moines, IA
Sources for this page
- 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.
- 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.