Individual provider Active NPI

William David Strayhorn IV, M.D., PH.D.

  • Neurology Physician
  • Frederick, MD
National Provider Identifier
1184722258
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2004024761 Issued in MO
Practice address
196 Thomas Johnson Dr
Suite 120
Frederick, MD 21702-4397
Phone
(240) 566-3130
Fax
(240) 566-3131
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2004024761 MO Primary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X D0071626 MD

Addresses

Primary practice location

196 Thomas Johnson Dr
Suite 120
Frederick, MD 21702-4397

Mailing address

PO Box 1806
Frederick, MD 21702-0806
Phone (240) 566-3130

Other identifiers 1

IdentifierTypeStateIssuer
2009001301OtherMOMO LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120216000044 MD Practitioner - Neurology 4880719772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Vanderbilt University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Neurology Services, PAGroup PAC ID 6103993126, 19 clinicians

Practice addresses (Care Compare)

196 Thomas Johnson Dr
Suite 120
Frederick, MD 21702-4521
Phone (240) 566-3130

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0071626MDMDNeuromusculoskeletal Medicine & OMM Physician
2004024761MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Neurology Services, P.a. CurrentSince Jan 16, 2012 Accepting new patients
Comprehensive Neurology Services, P.a. CurrentSince Jan 16, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

196 Thomas Johnson Dr
Ste 120
Frederick, MD 21702
Phone (240) 566-3130

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

11110 Medical Campus Rd
Ste 227
Hagerstown, MD 21742
Phone (301) 797-1900

Interoperability endpoints

  • Direct secure messaging: william.strayhorn@cnsp.eclinicaldirectplus.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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1184722258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1806",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217020806",
            "telephone_number": "240-566-3130",
            "fax_number": "240-566-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "SUITE 120",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "240-566-3130",
            "fax_number": "240-566-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAYHORN",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2004024761",
            "primary": true
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MD",
            "license": "D0071626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2009001301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.