Individual provider Active NPI

Deanann Farris, D.O.

  • Psychiatry Physician
  • Bradford, PA
National Provider Identifier
1174761217
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
3554 Issued in WV
Practice address
110 Campus Dr
Bradford, PA 16701-1982
Phone
(814) 362-6535
Fax
(814) 817-2113
NPI assigned
Jan 28, 2009
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 OT012801 PA
Psychiatry Physician 2084P0800X 3554 WV Primary

Addresses

Primary practice location

110 Campus Dr
Bradford, PA 16701-1982

Mailing address

110 Campus Dr
Bradford, PA 16701-1982
Phone (814) 362-6535

Other practice location 1

1464 Jefferson St N
Lewisburg, WV 24901-1380
Phone (304) 645-3220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WV2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140304001166 PA Practitioner - Psychiatry 3779713144 Reassigns benefits to 2 organizations
I20200721003820 WV Practitioner - Psychiatry 3779713144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Guidance CenterGroup PAC ID 6103864681, 13 clinicians

Practice addresses (Care Compare)

110 Campus Dr
Bradford, PA 16701-1982
Phone (814) 362-6535

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012801PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Center for Treatment and Education CurrentSince Feb 9, 2014 Accepting new patients
Childrens Center for Treatment and Education CurrentSince Feb 9, 2014 Accepting new patients
The Guidance Center CurrentSince Jan 10, 2025 Accepting new patients
West Virginia School of Osteopathic Medicine Clinic Inc D/B/a Robert C. Byrd Clinic CurrentSince Jun 1, 2020 Accepting new patients

Locations

110 Campus Dr
Bradford, PA 16701
Phone (814) 362-6535

23 Kennedy St
Bradford, PA 16701
Phone (814) 723-1832

1885 Market St
Warren, PA 16365
Phone (814) 723-1832

1464 Jefferson St N
Lewisburg, WV 24901
Phone (304) 647-5577

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.

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": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1174761217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011982",
            "telephone_number": "814-362-6535",
            "fax_number": "814-817-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011982",
            "telephone_number": "814-362-6535",
            "fax_number": "814-817-2113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1464 Jefferson St N",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "WV",
            "postal_code": "249011380",
            "country_code": "US",
            "telephone_number": "304-645-3220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "DEANANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OT012801",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "3554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

Verify at the official NPI Registry.