Individual provider Active NPI

Michael Patrick Dohrenwend, MD

  • Gastroenterology Physician
  • Huntsville, AL
National Provider Identifier
1922089598
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
16209 Issued in AL
Practice address
7738 Madison Blvd
Huntsville, AL 35806-2085
Phone
(256) 430-4427
Fax
(256) 430-4335
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 16209 AL Primary

Addresses

Primary practice location

7738 Madison Blvd
Huntsville, AL 35806-2085

Mailing address

420 Lowell Dr SE
Ste 103
Huntsville, AL 35801-3754
Phone (256) 535-5940

Other identifiers 4

IdentifierTypeStateIssuer
331103393OtherTAX IDENTIFICATION NO
51525690OtherALBLUE CROSS BLUE SHIELD
051525690MedicaidAL
0007315194OtherAETNA IDENTIFICATION NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20031124000574 AL Practitioner - Gastroenterology 1850295528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16209ALMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Digestive Disorders Center, PC Gastroenterology PastSince Sep 7, 2018 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCJJAA

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1922089598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE",
            "address_2": "STE 103",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013754",
            "telephone_number": "256-535-5940",
            "fax_number": "256-535-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7738 MADISON BLVD",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358062085",
            "telephone_number": "256-430-4427",
            "fax_number": "256-430-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHRENWEND",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "16209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NO",
            "identifier": "331103393",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51525690",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051525690",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA IDENTIFICATION NO",
            "identifier": "0007315194",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.