Individual provider Active NPI

David A Duesenberg, M.D.

  • Psychiatry Physician
  • Chesterfield, MO
National Provider Identifier
1962695452
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
110327 Issued in MO
Practice address
714 Spirit 40 Park Dr
Suite 145
Chesterfield, MO 63005-1146
Phone
(636) 536-9776
Fax
(636) 536-0984
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 110327 MO Primary

Addresses

Primary practice location

714 Spirit 40 Park Dr
Suite 145
Chesterfield, MO 63005-1146

Mailing address

714 Spirit 40 Park Dr
Suite 145
Chesterfield, MO 63005-1146
Phone (636) 536-9776

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
110327MOMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1962695452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 SPIRIT 40 PARK DR",
            "address_2": "SUITE 145",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051146",
            "telephone_number": "636-536-9776",
            "fax_number": "636-536-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 SPIRIT 40 PARK DR",
            "address_2": "SUITE 145",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051146",
            "telephone_number": "636-536-9776",
            "fax_number": "636-536-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUESENBERG",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "110327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.