Individual provider Active NPI

John E Pappenheim, MD

  • Psychiatry Physician
  • Juneau, AK
National Provider Identifier
1972666857
Registry record updated Dec 14, 2015
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Oct 20, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
TD60621749 Issued in WA
Practice address
3260 Hospital Dr
Juneau, AK 99801-7808
Phone
(907) 796-8900
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 27753 WI
Psychiatry Physician 2084P0800X TD60621749 WA Primary

Addresses

Primary practice location

3260 Hospital Dr
Juneau, AK 99801-7808

Mailing address

107S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

Other identifiers 1

IdentifierTypeStateIssuer
31471100MedicaidWI

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5470AKMDOrthopaedic Surgery Physician
27753WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Milwaukee Psychiatry Past Accepting new patients

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1972666857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651",
            "fax_number": "509-363-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017808",
            "telephone_number": "907-796-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPENHEIM",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "27753",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "TD60621749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31471100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.