Active NPI
David Forrest Colvin, MD
- Psychiatry Physician
- Bridgeport, WV
National Provider Identifier
1285669291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 10442
- Practice address
- 1160 Johnson Ave
Suite 105
Bridgeport, WV 26330 - Phone
- (304) 842-9084
- Fax
- (304) 842-9085
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 10442 | WV | Primary |
Addresses
Primary practice location
1160 Johnson Ave
Suite 105
Bridgeport, WV 26330
Mailing address
1160 Johnson Ave
Suite 105
Bridgeport, WV 26330
Phone (304) 842-9084
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0115368000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10442 | WV | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Associates | Psychiatry | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285669291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 JOHNSON AVE",
"address_2": "SUITE 105",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "26330",
"telephone_number": "304-842-9084",
"fax_number": "304-842-9085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 JOHNSON AVE",
"address_2": "SUITE 105",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "26330",
"telephone_number": "304-842-9084",
"fax_number": "304-842-9085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLVIN",
"first_name": "DAVID",
"middle_name": "FORREST",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WV",
"license": "10442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0115368000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, WV
- David Benjamin Cohen, M.D.
- Diana Lynne Colassesano, R.N.
- Tanner Grant Cole, FNP-C
- Dawn M Colley, LSW
- Jeffery S Collins, MA
- Community Care of West Virginia
- Community Care of West Virginia, Inc.
- Community Care of West Virginia, Inc.
- Community Care of West Virginia, Inc.
- Community Care of West Virginia, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.