Individual provider Active NPI

John Brian Dilley, ED.D.

  • Clinical Psychologist
  • Des Moines, IA
National Provider Identifier
1972647626
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
376 Issued in IA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1229OtherIAPROF. MOBILITY (ASPPB)
376OtherIAPSYCHOLOGIST
123OtherIAHEALTH SERVICE PROVIDER

Other names 1

  • Dr. John B. Dilley Professional name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
376IAMDClinical Psychologist
00376IAMDPhysical 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

Verify at the official NPI Registry.