Organization Active NPI

Brandon M Lingenfelter DO PHD

  • Obstetrics & Gynecology Physician
  • Princeton, WV
National Provider Identifier
1255788758
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3064 Issued in WV
Legal business name
BRANDON M LINGENFELTER DO PHD
Practice address
411 12TH Street Ext
Princeton, WV 24740-2300
Phone
(681) 282-5591
Fax
(681) 282-5593
NPI assigned
May 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Authorized official

Name
Brandon Michael Lingenfelter, D.O.NPI 1790045821
Title
Owner
Phone
(681) 282-5591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 3064 WV Primary

Addresses

Primary practice location

411 12TH Street Ext
Princeton, WV 24740-2300

Mailing address

411 12TH Street Ext
Princeton, WV 24740-2300
Phone (681) 282-5591

Other practice location 1

825 Davis St
Blacksburg, VA 24060-7009
Phone (681) 282-5591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160830001451 WV Part B Supplier - Clinic/Group Practice 4385939354 Receives reassigned benefits from 6 practitioners
Practice locations: Gary, WV; Princeton, WV
O20220625000590 VA Part B Supplier - Clinic/Group Practice 4385939354 Receives reassigned benefits from 2 practitioners
Practice locations: Blacksburg, VA

National Provider Directory

National Provider Directory

Locations

825 Davis St
Ste B2
Blacksburg, VA 24060
Phone (681) 282-5591

411 12th Street Ext
Princeton, WV 24740
Phone (681) 282-5591

608 New Hope Rd
Ste 2
Princeton, WV 24740
Phone (304) 425-0403

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16885/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1255788758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402300",
            "telephone_number": "681-282-5591",
            "fax_number": "681-282-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402300",
            "telephone_number": "681-282-5591",
            "fax_number": "681-282-5593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Davis St",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240607009",
            "country_code": "US",
            "telephone_number": "681-282-5591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRANDON M LINGENFELTER DO PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "LINGENFELTER",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "681-282-5591",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "3064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.