NPIMap

Individual provider Active NPI

Deidre D Redd, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Charleston, WV
National Provider Identifier
1306995865
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
31368 Issued in WV
Practice address
501 Morris St
Charleston, WV 25301-1326
Phone
(304) 388-5432
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 35073959R OH
Physical Medicine & Rehabilitation Physician 208100000X 31368 WV Primary

Addresses

Primary practice location

501 Morris St
Charleston, WV 25301-1326

Mailing address

400 Association Dr Ste 102
Charleston, WV 25311-1298
Phone (304) 388-1724

Other identifiers 2

IdentifierTypeStateIssuer
2140874MedicaidOH
000000228201OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MS, WV3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051019000555 OH Practitioner - Physical Medicine and Rehabilitation 1658397658 Reassigns benefits to 1 organization
I20181108000277 MS Practitioner - Physical Medicine and Rehabilitation 1658397658 Reassigns benefits to 1 organization
I20230919001842 WV Practitioner - Physical Medicine and Rehabilitation 1658397658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Wright State University Boonshoft School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Charleston Area Med CNTR Inpatient rehabilitation facility, Charleston, WV, CCN 51T022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6447OHMDClinical Child & Adolescent Psychologist
35073959ROHMDPhysical Medicine & Rehabilitation Physician
31368WVMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 6, 2023 Accepting new patients
Somc Medical Care Foundation, Inc. Physical Medicine & Rehabilitation CurrentSince Oct 20, 2014 Accepting new patients
Somc Medical Care Foundation, Inc. CurrentSince Oct 20, 2014 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 6, 2023 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Select Specialty Hospital - Columbus Inc Past Accepting new patients
Physical Medicine Associates, Inc. Physical Medicine & Rehabilitation Past Accepting new patients

Locations

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

Organizations & group practices 8

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 11

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1306995865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DR STE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111298",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-388-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDD",
        "first_name": "DEIDRE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35073959R",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WV",
            "license": "31368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2140874",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000228201",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.