Individual provider Active NPI

Dwight Saulle, MD

  • Neurological Surgery Physician
  • Huntington, WV
National Provider Identifier
1215195615
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
25975 Issued in WV
Practice address
2860 3Rd Ave
Suite 10
Huntington, WV 25702-1454
Phone
(304) 525-6825
Fax
(304) 525-0300
NPI assigned
Jun 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 25975 WV Primary

Addresses

Primary practice location

2860 3Rd Ave
Suite 10
Huntington, WV 25702-1454

Mailing address

PO Box 4190
Barboursville, WV 25504-4190
Phone (304) 399-4405

Other practice location 1

2900 1st Ave Ste 10
Huntington, WV 25702-1241
Phone (304) 525-6825

Other identifiers 2

IdentifierTypeStateIssuer
0106256MedicaidOH
3810027553MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwight.saulle@smmm.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, KY2 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
I20140903001167 WV Practitioner - Neurosurgery 0840427084 Reassigns benefits to 1 organization
I20210419002605 KY Practitioner - Neurosurgery 0840427084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

1290 Montgomery Ave
Ashland, KY 41101-2776
Phone (606) 329-8400

2400 13TH St
Ashland, KY 41102-4510
Phone (606) 329-0910

2828 1St Ave
Huntington, WV 25702-1241

2900 1St Ave
Huntington, WV 25702-1241

710 N Carol Malone Boulevard
Grayson, KY 41143-1126
Phone (606) 474-0157

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion174
Laminectomy or laminotomy (partial removal of spine bones)59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25975WVMDNeurological Surgery Physician

Organizations & group practices 1

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 6

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1215195615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190",
            "telephone_number": "304-399-4405",
            "fax_number": "304-399-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 3RD AVE",
            "address_2": "SUITE 10",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021454",
            "telephone_number": "304-525-6825",
            "fax_number": "304-525-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 1st Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257021241",
            "country_code": "US",
            "telephone_number": "304-525-6825",
            "fax_number": "304-525-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAULLE",
        "first_name": "DWIGHT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WV",
            "license": "25975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106256",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810027553",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwight.saulle@smmm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2900 1st Ave Ste 10",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257021241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.