DR. DIETRICH ALBERT FELLNER (NPI# 1922097179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922097179 |
| Entity Type | Individual |
| Full Name | DR. DIETRICH ALBERT FELLNER |
| Credential | M.D. |
| Practice Address |
813 Independence Blvd Virginia Beach VA 23455-6004 |
| Practice Telephone | 7574909091 |
| Practice Fax Number | 7574903250 |
| Mailing Telephone | 7574909091 |
| Mailing Fax Number | 7574903250 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2013-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 0101232452 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010030013 | 05 | |
| VA | ANTHEM BLUE CROSS | 110252 | 01 |
| VA | TRICARE | 541206650 | 01 |
| Street Address |
813 INDEPENDENCE BLVD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23455-6004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588040695 | David Domachowski | Optometrist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2015-07-31 |
| 1376775098 | Mary Lanier Huntley-wagner | Nurse Practitioner | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2009-08-13 |
| 1770678450 | Independence Family Medicine | Family Medicine | 813 Independence Blvd, Suite A, Virginia Beach, VA 23455-6004 | 2006-10-04 |
| 1720179104 | The Eye Specialists Ltd | Optometrist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2006-09-28 |
| 1760456511 | Michael Vincent Moro | Family Medicine | 813 Independence Blvd, Suite A, Virginia Beach, VA 23455-6004 | 2006-02-16 |
| 1164411310 | Christine Ware Cook | Optometrist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2005-10-20 |
| 1124017363 | Russell Nmn Meyer | Specialist | 813 Independence Blvd, Virginia Beach, VA 23455-6004 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324162 | Evoscient Gynecology Center for Pelvic Health and Surgery, PC | Obstetrics & Gynecology | 108 Independence Blvd, Suite 162, Virginia Beach, VA 23455 | 2020-07-24 |
| 1942728571 | Delois L Dillard | Occupational Therapy Assistant | 4225 Shore Drive, Virginia Beach, VA 23455 | 2017-09-04 |
| 1295255404 | Unobs Medical Transportation Services LLC | Non-emergency Medical Transport (VAN) | 5812 Tajo Avenue, Virginia Beach, VA 23455 | 2017-06-20 |
| 1831640812 | Wearefit | Dietitian, Registered | 4752 Hollis Road, Virginia Beach, VA 23455 | 2016-10-14 |
| 1629496633 | Jamie Lauren Dermatis | Podiatrist | 1700 Pleasure Road, #101, Virginia Beach, VA 23455 | 2014-04-07 |
| 1619304664 | Syed A Absar | Pharmacist | 4828 Lake Bradford Lane, Virginia Beach, VA 23455 | 2013-10-07 |
| 1851734958 | Cara K Richardson | Occupational Therapist | 2364 Madison Ave., Virginia Beach, VA 23455 | 2013-04-09 |
| 1811249287 | Chl & Associates | Nurse Practitioner | 1367 Sir Richard Rd, Virginia Beach, VA 23455 | 2012-10-10 |
| 1588915425 | Edward S Wilson | Physician Assistant | 604 Bishop Dr, Virginia Beach, VA 23455 | 2012-10-01 |
| 1073886842 | April Gilbrech | Registered Nurse | 1103 Canopy Ct, Virginia Beach, VA 23455 | 2012-02-09 |
| Find all providers in zip 23455 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679743645 | American Association of Professional Eye Care Specialists Aapecs P C | Ophthalmology | 279 Independence Blvd, Virginia Beach, VA 23462-2903 | 2008-03-06 |
| 1033208830 | Earl Russell Crouch Jr. | Ophthalmology | 4665 South Blvd, Virginia Beach, VA 23452-1055 | 2006-10-12 |
| 1437260809 | Waller L Taylor Jr. | Ophthalmology | 1821 Old Donation Parkway, Suite 1, Virginia Beach, VA 23454-3033 | 2006-08-31 |
| 1053370007 | Douglas Mercer Rampona | Ophthalmology | 848 First Colonial Rd, Virginia Beach, VA 23451-6126 | 2006-03-20 |
| 1134104045 | Teresa A Shenouda | Ophthalmology | 828 Healthy Way Ste 200, Virginia Beach, VA 23462-7961 | 2005-12-13 |
| 1669456166 | Marcia Denise Carney | Ophthalmology | 4433 Corporation Ln, Corporation Iv Suite 195, Virginia Beach, VA 23462-3351 | 2005-11-30 |
| 1902807449 | Aris Philip Delianides | Ophthalmology | 1012 First Colonial Rd, Virginia Beach, VA 23454-3072 | 2005-08-09 |
| 1205834975 | Reynaldo Molina Francisco | Ophthalmology | 5265 Providence Rd, Ste 505, Virginia Beach, VA 23464-4206 | 2005-07-07 |
| 1093189912 | Aapecs Services, LLC | Ophthalmology | 279 Independence Blvd, Virginia Beach, VA 23462-2903 | 2015-11-16 |
| 1871984716 | Virginia Medical Eye Center | Ophthalmology | 848 First Colonial Rd, Suite A, Virginia Beach, VA 23451-6126 | 2015-02-13 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23455 |
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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.