Individual provider Active NPI

D Duane Berry, DO

  • Family Medicine Physician
  • South Charleston, WV
National Provider Identifier
1730174145
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1349 Issued in WV
Practice address
5220 Maccorkle Ave SW
South Charleston, WV 25309-1010
Phone
(304) 720-6735
Fax
(304) 720-6737
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1349 WV Primary

Addresses

Primary practice location

5220 Maccorkle Ave SW
South Charleston, WV 25309-1010

Mailing address

5220 Maccorkle Ave SW
South Charleston, WV 25309-1010
Phone (304) 720-6735

Other practice location 1

5430 MacCorkle Ave SE
Charleston, WV 25304-2224
Phone (304) 925-3627

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
I20101018000784 WV Practitioner - Family PracticePractitioner - Emergency Medicine 0840251047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1349WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care PLLC-Morgantown Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dberry20595@gohealthupmc.direct-ci.com

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1730174145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091010",
            "telephone_number": "304-720-6735",
            "fax_number": "304-720-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091010",
            "telephone_number": "304-720-6735",
            "fax_number": "304-720-6737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5430 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253042224",
            "country_code": "US",
            "telephone_number": "304-925-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "D DUANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.