Active NPI
Michael Patrick Dohrenwend, MD
- Gastroenterology Physician
- Huntsville, AL
National Provider Identifier
1922089598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 16209
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331103393 | Other | TAX IDENTIFICATION NO | |
| 51525690 | Other | AL | BLUE CROSS BLUE SHIELD |
| 051525690 | Medicaid | AL | |
| 0007315194 | Other | AETNA 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031124000574 | AL | Practitioner - Gastroenterology | 1850295528 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16209 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama Digestive Disorders Center, PC | Gastroenterology | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Gastroenterology Physician
- Huntsville, AL
- NPI 1912946385
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.