Individual provider Active NPI

Michael Deprospero, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Charleston, WV
National Provider Identifier
1801251525
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3200 Maccorkle Ave SE
Camc Family Medicine Center
Charleston, WV 25304-1227
Phone
(304) 388-4600
Fax
(304) 388-4621
NPI assigned
Dec 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Camc Family Medicine Center
Charleston, WV 25304-1227

Mailing address

3200 Maccorkle Ave SE
Camc Family Medicine Center
Charleston, WV 25304-1227
Phone (304) 388-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190205002410 NC Practitioner - Family Practice 0143527911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

351 Wellesley Trade LN
Suite 100
Cary, NC 27519-5669
Phone (919) 576-8100

7200 Creedmoor Rd
Suite 208
Raleigh, NC 27613-1711
Phone (919) 327-1650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Jan 7, 2019 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Jan 7, 2019 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Past Accepting new patients

Locations

351 Wellesley Trade Ln
Ste 100
Cary, NC 27519
Phone (919) 576-8100

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Interoperability endpoints

  • Direct secure messaging: mdeprospero415329@direct.medicine.duke.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1801251525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "address_2": "CAMC FAMILY MEDICINE CENTER",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4600",
            "fax_number": "304-388-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "address_2": "CAMC FAMILY MEDICINE CENTER",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4600",
            "fax_number": "304-388-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPROSPERO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.