Active NPI
Donna Sue Dispanet, RN
- Registered Nurse
- Petersburg, WV
National Provider Identifier
1780308452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 102330
- Practice address
- 100 Hospital Dr Ste 3
Petersburg, WV 26847-9570 - Phone
- (304) 257-1015
- Fax
- (304) 257-1129
- NPI assigned
- Sep 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 102330 | WV | Primary |
Addresses
Primary practice location
100 Hospital Dr Ste 3
Petersburg, WV 26847-9570
Mailing address
64 Blueberry Dr
Mathias, WV 26812-8351
Phone (540) 325-6436
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Desktop/Tablet |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102330 | WV | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grant Memorial Homecare and Hospice LLC | Current | Accepting new patients | |
| Grant Memorial Homecare and Hospice, LLC | Past | Accepting new patients |
Locations
100 Hospital Dr
Ste 3
Petersburg, WV 26847
Phone (304) 257-1015
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 and National Provider Directory roles.
-
- Home Health Agency
- Petersburg, WV
- NPI 1104084151
-
- Community Based Hospice Care Agency
- Petersburg, WV
- NPI 1053579102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1780308452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 BLUEBERRY DR",
"city": "MATHIAS",
"state": "WV",
"postal_code": "268128351",
"telephone_number": "540-325-6436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL DR STE 3",
"city": "PETERSBURG",
"state": "WV",
"postal_code": "268479570",
"telephone_number": "304-257-1015",
"fax_number": "304-257-1129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISPANET",
"first_name": "DONNA",
"middle_name": "SUE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-27",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WV",
"license": "102330",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Desktop/Tablet",
"affiliation": "N",
"address_1": "100 Hospital Dr Ste 3",
"city": "Petersburg",
"state": "WV",
"country_code": "US",
"postal_code": "268479570",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Petersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.