Active NPI
William G Danneman, MD
- Medical Oncology Physician
- Edgewood, KY
National Provider Identifier
1619960416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- 21239
- Practice address
- 1 Medical Village Dr
Edgewood, KY 41017-3403 - Phone
- (859) 301-4000
- Fax
- (859) 301-4001
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 21239 | KY | |
| Hematology & Oncology Physician | 207RH0003X | 35040832 | OH | |
| Medical Oncology Physician | 207RX0202X | 35.040832 | OH | |
| Medical Oncology Physician | 207RX0202X | 21239 | KY | Primary |
Addresses
Primary practice location
1 Medical Village Dr
Edgewood, KY 41017-3403
Mailing address
PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-4000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64784036 | Medicaid | KY | |
| 900003566 | Other | KY | MEDICARE RAILROAD |
| 0505288 | Medicaid | OH | |
| 900003535 | Other | OH | MEDICARE RAILROAD |
| 200070390 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35040832 | OH | MD | Hematology & Oncology Physician |
| 35.040832 | OH | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oncology/ Hematology Care, Inc. | Hematology & Oncology | Past | Accepting new patients |
| Oncology Hematology Care Inc | Hematology & Oncology | Past | Accepting new patients |
Interoperability endpoints
- wdanneman24811@direct-prd.stelizabeth.com
Organizations & group practices 3
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.
-
- Medical Oncology Physician
- Cincinnati, OH
- NPI 1790778041
Hematology & Oncology
-
- Medical Oncology Physician
- Lawrenceburg, IN
- NPI 1164426813
Hematology & Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1619960416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 636324",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452636324",
"telephone_number": "859-301-4000",
"fax_number": "859-301-4001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL VILLAGE DR",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173403",
"telephone_number": "859-301-4000",
"fax_number": "859-301-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANNEMAN",
"first_name": "WILLIAM",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "KY",
"license": "21239",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "OH",
"license": "35040832",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "OH",
"license": "35.040832",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "KY",
"license": "21239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64784036",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "900003566",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0505288",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "900003535",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200070390",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.