Nancy E Brunner, M.D.
Individual provider Active NPI Pediatrics Physician · Morgantown, WV
NPI 1205926680 · NPPES record last updated Apr 15, 2022
Key facts
- NPI
- 1205926680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 20181 (WV)
- Practice address
- 1 Stadium Drive
Morgantown, WV 26506 - Phone
- (304) 598-4800
- Fax
- (304) 598-6873
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040914000950 | WV | Practitioner - Pediatric Medicine | 7214904739 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20181 | WV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Virginia University Medical Corporation | Pediatrics | Current | Accepting new patients |
| West Virginia University Medical Corporation | Current |
Accepting new patients | |
| Health and Education Building | Current |
Accepting new patients |
Locations
1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500
6040 University Town Centre Dr
Morgantown, WV 26501
Interoperability endpoints
- nbrunner465@direct.wvuhsdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20181 | WV | Yes |
Addresses
Primary practice location
1 Stadium Drive
Morgantown, WV 26506
Mailing address
PO Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1807525000 | Medicaid | WV |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nbrunner465@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | nbrunner465@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | nbrunner465@direct.wvuhsdirect.com | Health Information Exchange (HIE) |
Other providers in Morgantown, WV
- Thomas A Brugnoli
- Madeline Brumfield
- Sandy Brundage
- Adam M Bruner
- Matthew D Brunner
- Anthony Robert Bruno
- Christine M Bruno
- Shannon Brunzo-Hager
- Nicole Beth Bryan
- Nicole P Bryan
All providers in Morgantown, WV · Pediatrics Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.