Individual provider Active NPI

Jana K Dreyzehner, MD

  • Psychiatry Physician
  • Clintwood, VA
National Provider Identifier
1063407773
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101055915 Issued in VA
Practice address
312 Hospital Dr
Clintwood, VA 24228-6786
Phone
(276) 356-5262
Fax
(615) 523-1589
NPI assigned
Sep 19, 2005
Last updated
Jan 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101055915 VA Primary
Child & Adolescent Psychiatry Physician 2084P0804X MD0000029394 TN

Addresses

Primary practice location

312 Hospital Dr
Clintwood, VA 24228-6786

Mailing address

415 Church St
#2802
Nashville, TN 37219-2308
Phone (276) 356-5262

Other identifiers 3

IdentifierTypeStateIssuer
260041732OtherVAMEDICARE RAILROAD
004945522MedicaidVA
326864OtherVABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN, MN, NM, NC5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20050627001183 VA Practitioner - Psychiatry 2860437142 Reassigns benefits to 1 organization
Practice locations: Clintwood, VA
I20131118000429 TN Practitioner - Psychiatry 2860437142 Reassigns benefits to 2 organizations
Practice locations: Johnson City, TN; Waverly, TN; Nashville, TN
I20200609000700 MN Practitioner - Psychiatry 2860437142 Reassigns benefits to 1 organization
I20230801003534 NM Practitioner - Psychiatry 2860437142 Reassigns benefits to 1 organization
I20230831001134 NC Practitioner - Psychiatry 2860437142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

110 E Broadway St
Hobbs, NM 88240-8424
Phone (844) 800-2735

415 Church St
Apt 2802
Nashville, TN 37219-1829

415 Church St
Apt 2802
Nashville, TN 37219-1847
Phone (844) 800-2735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteers of America MN/Wi Current Accepting new patients
Volunteers of America of Minnesota CurrentSince May 12, 2020 Accepting new patients
Volunteers of America MN/Wi CurrentSince May 12, 2020 Accepting new patients
Life Connect Health LLC Child & Adolescent Psychiatry CurrentSince Oct 1, 2014 Accepting new patients

Locations

7625 Metro Blvd
Ste 200
Minneapolis, MN 55439
Phone (952) 945-4092

9220 Bass Lake Rd
Ste 255
New Hope, MN 55428
Phone (763) 225-4052

2626 Glenwood Ave
Ste 550
Raleigh, NC 27608
Phone (203) 518-2124

110 E Broadway St
Hobbs, NM 88240
Phone (844) 800-2735

302 Wesley St
Ste 10
Johnson City, TN 37601
Phone (423) 928-8801

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1063407773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 CHURCH ST",
            "address_2": "#2802",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192308",
            "telephone_number": "276-356-5262",
            "fax_number": "615-523-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 HOSPITAL DR",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242286786",
            "telephone_number": "276-356-5262",
            "fax_number": "615-523-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYZEHNER",
        "first_name": "JANA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101055915",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "MD0000029394",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "260041732",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945522",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "326864",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clintwood, VA

Sources for this page

Verify at the official NPI Registry.