Individual provider Active NPI

Timothy D.W. Canterbury, MD

  • Surgery Physician
  • Huntington, WV
National Provider Identifier
1083674790
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
14461 Issued in WV
Practice address
1600 Medical Center Dr
Suite 2500
Huntington, WV 25701-3656
Phone
(304) 691-1200
Fax
(304) 691-1287
NPI assigned
Mar 25, 2006
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 14461 WV Primary
Surgical Critical Care Physician 2086S0102X 14461 WV

Addresses

Primary practice location

1600 Medical Center Dr
Suite 2500
Huntington, WV 25701-3656

Mailing address

1600 Medical Center Dr
Suite 2500
Huntington, WV 25701-3656
Phone (304) 691-1200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.canterbury@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: timothy.canterbury@marshall.cernerdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1083674790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE 2500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1200",
            "fax_number": "304-691-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE 2500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1200",
            "fax_number": "304-691-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERBURY",
        "first_name": "TIMOTHY",
        "middle_name": "D.W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "14461",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WV",
            "license": "14461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.canterbury@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite 2500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.