Virginia Carol Duerst, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1354 Issued in WI

Practice address

10000 Otter Creek Road
Fall Creek, WI 54742

Phone

(715) 877-2320

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Virginia Carol Duerst Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972614113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 OTTER CREEK ROAD",
            "city": "FALL CREEK",
            "state": "WI",
            "postal_code": "54742",
            "telephone_number": "715-877-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 OTTER CREEK ROAD",
            "city": "FALL CREEK",
            "state": "WI",
            "postal_code": "54742",
            "telephone_number": "715-877-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUERST",
        "first_name": "VIRGINIA",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39218700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "DUERST",
            "middle_name": "CAROL",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Angela Rae Barribeau
• Katharine Borreson
• Colette S. Cline, RDH
• Daniel Cook, RN
• Covenant Care LLC (Fall Creek Valley Care Center)
• Enigma Psychological Inc.
• Fall Creek Chiropractic Inc.
• Fall Creek Dental
• Fall Creek Family Dental, LLC
• Fall Creek Pharmacy, Inc. (Fall Creek Pharmacy)

• Psychologist in Fall Creek, WI
• Providers in Fall Creek, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.