Individual provider Active NPI

Stephen Durrenberger, MD

  • Psychiatry Physician
  • Huntington, WV
National Provider Identifier
1063526861
Registry record updated Jul 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
19772 Issued in WV
Practice address
5317 Cherry Lawn Rd
Huntington, WV 25705-2032
Phone
(304) 302-2078
Fax
(304) 302-7260
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 19772 WV Primary

Addresses

Primary practice location

5317 Cherry Lawn Rd
Huntington, WV 25705-2032

Mailing address

5317 Cherry Lawn Rd
Huntington, WV 25705-2032
Phone (304) 302-2078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, DC, MD3 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
I20050302000280 WV Practitioner - Psychiatry 2961455928
I20200728003671 DC Practitioner - Psychiatry 2961455928 Reassigns benefits to 1 organization
I20200729000209 MD Practitioner - Psychiatry 2961455928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axis Healthcare GroupGroup PAC ID 1254409550, 76 clinicians

Practice addresses (Care Compare)

25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone (202) 360-4787

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Healthcare Group Psychiatry CurrentSince Jul 1, 2020 Accepting new patients
MCS, PC Psychiatry Past Accepting new patients
St Marys Hospital of St Marys County Inc Past Accepting new patients

Locations

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

10400 Connecticut Ave
Ste 500
Kensington, MD 20895
Phone (202) 363-2575

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

Interoperability endpoints

  • Direct secure messaging: durrenberger.stephen.010.0480015@frmcp.meditab.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247270400000",
    "number": "1063526861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 CHERRY LAWN RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052032",
            "telephone_number": "304-302-2078",
            "fax_number": "304-302-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 CHERRY LAWN RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052032",
            "telephone_number": "304-302-2078",
            "fax_number": "304-302-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRENBERGER",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "19772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.