JOHN C DEITRICK (NPI# 1457338741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457338741 |
| Entity Type | Individual |
| Full Name | JOHN C DEITRICK |
| Credential | MD |
| Practice Address |
1051 Johnston Willis Dr Ste 200 Richmond VA 23235 |
| Practice Telephone | 8043202705 |
| Practice Fax Number | 8043302433 |
| Mailing Telephone | 8043202705 |
| Mailing Fax Number | 8043302433 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2010-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
0101037598 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1457338741 | 05 | |
| VA | 7354380 | 05 |
| Street Address |
1051 JOHNSTON WILLIS DR STE 200 |
| City | RICHMOND |
| State | VA |
| Zip Code | 23235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578072492 | Kiana Maghamez | Physician Assistant | 1051 Johnston Willis Dr, #200, Richmond, VA 23235 | 2017-09-22 |
| 1023227345 | Diane Renee Cox | Surgery | 1051 Johnston Willis Dr, St 200, Richmond, VA 23235-4871 | 2007-05-22 |
| 1881612372 | Surgical Associates of Richmond, Inc | Surgery | 1051 Johnston Willis Dr, Ste 200, Richmond, VA 23235 | 2006-07-17 |
| 1700863818 | Martin T Evans | Surgery | 1051 Johnston Willis Dr, St 200, Richmond, VA 23235 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275770 | Melani Jones | Social Worker | 10825 Midlothian Turnpike Ste 201r, Richmond, VA 23235 | 2020-08-12 |
| 1447880109 | Sara Hudson | Pharmacist | 2821 Hicks Rd, North Chesterfield, VA 23235 | 2020-01-22 |
| 1730729096 | Mary Tabitha Varney | Counselor | 101 Buford Rd. Unit 110, North Chesterfield, VA 23235 | 2020-01-14 |
| 1093355133 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2015 Huguenot Road, North Chesterfield, VA 23235 | 2020-01-07 |
| 1255975983 | Louise Rutledge | Psychiatry & Neurology | 1429 Buford Rd, N. Chesterfield, VA 23235 | 2019-11-06 |
| 1114489317 | Therapeutic Learning Consortium LLC | Counselor | 8154 Forest Hill Ave Ste 2, North Chesterfield, VA 23235 | 2019-04-05 |
| 1013400332 | Shawmika Wright | Social Worker | 1301 Whitehead Road, Richmond, VA 23235 | 2018-06-11 |
| 1912490608 | Cara Whiting | Physical Therapist | 1400 Johnston Willis Dr Ste B, North Chesterfield, VA 23235 | 2018-06-07 |
| 1003324682 | David E Fortin | Hearing Instrument Specialist | 10441 Midlothian Turnpike, Richmond, VA 23235 | 2018-01-17 |
| 1053836544 | Hannah Katherine Chisholm | Physical Therapist | 1400 Johnston-willis Drive, Richmond, VA 23235 | 2017-08-07 |
| Find all providers in zip 23235 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346503463 | Mid Atlantic Vascular Holding, LLC | Surgery | 1415 Eastridge Rd, Richmond, VA 23229-5501 | 2012-06-22 |
| 1770531618 | Barklie Waters Zimmerman | Surgery | 7811 Forest Avenue, Suite 300, Richmond, VA 23229-4920 | 2006-05-04 |
| 1841258332 | Gerardo Joaquin Angel Mendez-picon | Surgery | 7611 Forest Avenue, Suite 300, Richmond, VA 23229-4920 | 2006-05-03 |
| 1083055487 | Michele Richard | Surgery | 1250 E Marshall St, Richmond, VA 23298 | 2013-07-13 |
| 1730405127 | Andrew Evans Leake | Surgery | 417 Libbie Ave, Richmond, VA 23226-2615 | 2010-04-11 |
| 1740414861 | Joshua A Wilensky | Surgery | 1100 Reid Pkwy Ste 215, Richmond, IN 47374-1157 | 2009-05-04 |
| 1427267822 | Michael Fiore Amendola | Surgery | 1250 E Marshall St, Surgery, Richmond, VA 23298-5051 | 2007-05-22 |
| 1033292313 | Francisco Cabral Albuquerque Jr. | Surgery | 1250 E Marshall St, Surgery, Richmond, VA 23298-5051 | 2006-10-23 |
| 1821193921 | Mark M Levy | Surgery | 1250 E Marshall St, Surgery/ Vascular, Richmond, VA 23298-5051 | 2006-09-13 |
| 1881612372 | Surgical Associates of Richmond, Inc | Surgery | 1051 Johnston Willis Dr, Ste 200, Richmond, VA 23235 | 2006-07-17 |
| Find all providers in RICHMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.