John William Dettwyler, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

B10000210 Issued in DE

Practice address

5301 Limestone Rd
Suite 103
Wilmington, DE 19808-1250

Phone

(302) 234-8982

Fax

(302) 234-8984

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

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

Specialty

Clinical Psychologist

Education

Temple University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Affinity Health, L.L.C.

  • Clinical Psychologist
  • Wilmington, DE
  • NPI 1245316694
  NPD (past)
• Mark P. Carney Psy.D. Inc

  • Counseling Psychologist
  • Wilmington, DE
  • NPI 1679753578
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982776324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 LIMESTONE RD",
            "address_2": "SUITE 103",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081250",
            "telephone_number": "302-234-8982",
            "fax_number": "302-234-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 LIMESTONE RD",
            "address_2": "SUITE 103",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081250",
            "telephone_number": "302-234-8982",
            "fax_number": "302-234-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTWYLER",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DE",
            "license": "B10000210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000025979",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000621543",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Desimone Jr.
• Erin Desmond, PT, DPT
• Peter M Desroches, PTA
• Falon Desselle, LCSW
• Marissa Destefano, PA-C
• Johanna Foster Detwiler, PA-C
• Charlene Miltz Deuber, APRN
• Ellen S. Deutsch, MD
• Stephanie Anne Deutsch, M.D.
• Dan Michael Devano, DO

• Psychologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Psychologist in Delaware

• 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.

Verify at the official NPI Registry.