Individual provider Active NPI

Laura G Denunzio, MD

  • Psychiatry Physician
  • Ballwin, MO
National Provider Identifier
1760694442
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
FD2363911 Issued in AZ
Practice address
323 Consort Dr
Ballwin, MO 63011-4439
Phone
(804) 433-1040
NPI assigned
May 4, 2007
Last updated
Apr 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101248017 VA
Psychiatry Physician 2084P0800X FD2363911 AZ Primary

Addresses

Primary practice location

323 Consort Dr
Ballwin, MO 63011-4439

Mailing address

323 Consort Dr
Ballwin, MO 63011-4439
Phone (804) 433-1040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130215000050 VA Practitioner - Psychiatry 9739352550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Virginia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Danville Pittsylvania Community ServicesGroup PAC ID 6608760046, 8 clinicians

Practice addresses (Care Compare)

245 Hairston St
Danville, VA 24540-4137
Phone (434) 799-0456

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FD2363911AZMDPsychiatry Physician
0101248017VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Danville-Pittsylvania Community Services CurrentSince May 7, 2013 Accepting new patients
Community Partners Integrated Healthcare, Inc. Past Accepting new patients
Horizon Behavioral Health PastSince Jan 4, 2012 Accepting new patients

Locations

245 Hairston St
Danville, VA 24540
Phone (434) 799-0456

515 Rison St
Danville, VA 24541
Phone (434) 793-5500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1760694442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "804-433-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "804-433-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENUNZIO",
        "first_name": "LAURA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101248017",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "FD2363911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.