Individual provider Active NPI

Jill Suzanne Bange, MD

  • Psychiatry Physician
  • Huntington, WV
National Provider Identifier
1548880362
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
33534 Issued in WV
Practice address
1115 20TH St
Huntington, WV 25703-2071
Phone
(304) 691-1500
NPI assigned
Apr 22, 2020
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 33534 WV Primary

Addresses

Primary practice location

1115 20TH St
Huntington, WV 25703-2071

Mailing address

1448 10TH Ave Ste 304
Huntington, WV 25701-3579
Phone (304) 691-6381

Other practice location 1

1 John Marshall Dr
Point Pleasant, WV 25550-1749
Phone (304) 691-1500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jill.bange@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240903002617 WV Practitioner - Psychiatry 2567901606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1115 20TH St
Suite 205
Huntington, WV 25703-2071
Phone (304) 691-1500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Jul 1, 2024 Accepting new patients
University Physicians & Surgeons, Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

1115 20th St
Huntington, WV 25703
Phone (304) 399-4121

1115 20th St
Ste 205
Huntington, WV 25703
Phone (304) 691-1100

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1 John Marshall Dr
Point Pleasant, WV 25550
Phone (304) 733-8735

Interoperability endpoints

  • Direct secure messaging: jill.bange@marshall.cernerdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1548880362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE STE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-691-6381",
            "fax_number": "304-691-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032071",
            "telephone_number": "304-691-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 John Marshall Dr",
            "address_purpose": "LOCATION",
            "city": "Point Pleasant",
            "state": "WV",
            "postal_code": "255501749",
            "country_code": "US",
            "telephone_number": "304-691-1500",
            "fax_number": "304-691-1510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANGE",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "33534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jill.bange@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1115 20th St",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257032071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.