Enrique Collantes Sta. Ana Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11628 Issued in WV

Practice address

1100 Hospital Dr
Hurricane, WV 25526-8712

Phone

(304) 757-8683

Fax

(304) 757-8684

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1295840593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HOSPITAL DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268712",
            "telephone_number": "304-757-8683",
            "fax_number": "304-757-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STA. ANA",
        "first_name": "ENRIQUE",
        "middle_name": "COLLANTES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056202000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MSBCBS",
            "identifier": "000416134",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "550641245",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Spaulding
• Spectrum Family Care, PLLC
• Spradling Medical & Treatment LLC
• Justin Reed Spradling, MD
• Lisa Spradling, NP
• David Shawn Stclair
• Kimberly D Steele
• Christopher R Stephens, DPT
• Doyle Dawon Stephens, D.O.
• Bryan Stephey, LPC, NCC, CCMHC

• Family Medicine Physician in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.