Individual provider Active NPI

Ronald J Innerfield, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Huntington, WV
National Provider Identifier
1063457950
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036167675 Issued in IL
Practice address
1249 15TH St Ste 3000
Huntington, WV 25701
Phone
(304) 691-1000
NPI assigned
Jun 17, 2006
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036167675 IL Primary
Internal Medicine Physician 207R00000X 036167675 IL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 118187 NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 68290 WI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X M-1859 GU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 28167 WV
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD61132366 WA

Addresses

Primary practice location

1249 15TH St Ste 3000
Huntington, WV 25701

Mailing address

1249 15TH St Ste 4093
Huntington, WV 25701-3662

Other practice location 1

133 Route 3
Dededo, GU 96929-6544
Phone (671) 645-5500 ext. 5544

Other practice location 2

133 Route 3
Dededo, GU 96929-6544
Phone (671) 645-5500 ext. 5544

Other practice location 3

105 W 8th Ave Ste 7010
Spokane, WA 99204-2312
Phone (509) 353-3901

Other practice location 4

3700 W 203rd St Ste 310
Olympia Fields, IL 60461-1182
Phone (708) 679-2130

Other identifiers 1

IdentifierTypeStateIssuer
02760016MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ronald.innerfield@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, IL, MN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20181015003425 WV Practitioner - EndocrinologyPractitioner - Internal Medicine 0446222772
I20240311000416 IL Practitioner - Endocrinology 0446222772 Reassigns benefits to 1 organization
I20250324001831 MN Practitioner - Endocrinology 0446222772

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
New York University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 5074
Sioux Falls, SD 57117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-1859GUMDEndocrinology, Diabetes & Metabolism Physician
036167675ILMDEndocrinology, Diabetes & Metabolism Physician
118187NYMDEndocrinology, Diabetes & Metabolism Physician
28167WVMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes & Metabolism LLC Endocrinology, Diabetes & Metabolism Current Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Physician Services Corporation of Southern Illinois Inc. Internal Medicine CurrentSince Dec 27, 2023 Accepting new patients

Locations

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

2 Good Samaritan Way
Ste 420
Mount Vernon, IL 62864
Phone (618) 899-4000

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

Interoperability endpoints

  • Direct secure messaging: ronald.innerfield@marshall.cernerdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1063457950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 15TH ST STE 4093",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 15TH ST STE 3000",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25701",
            "telephone_number": "304-691-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Route 3",
            "address_purpose": "LOCATION",
            "city": "Dededo",
            "state": "GU",
            "postal_code": "969296544",
            "country_code": "US",
            "telephone_number": "671-645-5500 x5544",
            "fax_number": "671-645-5549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 Route 3",
            "address_purpose": "LOCATION",
            "city": "Dededo",
            "state": "GU",
            "postal_code": "969296544",
            "country_code": "US",
            "telephone_number": "671-645-5500 x5544",
            "fax_number": "671-645-5549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 W 8th Ave Ste 7010",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042312",
            "country_code": "US",
            "telephone_number": "509-353-3901",
            "fax_number": "509-227-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3700 W 203rd St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611182",
            "country_code": "US",
            "telephone_number": "708-679-2130",
            "fax_number": "708-679-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INNERFIELD",
        "first_name": "RONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036167675",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036167675",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "118187",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "68290",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GU",
            "license": "M-1859",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WV",
            "license": "28167",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WA",
            "license": "MD61132366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02760016",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ronald.innerfield@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1249 15th St Ste 3000",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.