NPIMap

Organization Active NPI

Charleston Nephrology Hypertension and Transplant, PLLC

  • Nephrology Physician
  • South Charleston, WV
National Provider Identifier
1003017823
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
22697 Issued in WV
Legal business name
CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC
Practice address
4825 Maccorkle Ave SW
Suite a
South Charleston, WV 25309
Phone
(304) 400-4700
Fax
(304) 693-2606
NPI assigned
May 30, 2007
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Dr. Abdul Rahman Zanabli, M.D.NPI 1487752093
Title
Medical Director
Phone
(304) 400-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 22697 WV Primary

Addresses

Primary practice location

4825 Maccorkle Ave SW
Suite a
South Charleston, WV 25309

Mailing address

4825 Maccorkle Ave SW
Suite a
South Charleston, WV 25309
Phone (304) 400-4700

Other identifiers 2

IdentifierTypeStateIssuer
3810010603MedicaidWV
001953144OtherWVBC BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070808000398 WV Part B Supplier - Clinic/Group Practice 0042301814 Receives reassigned benefits from 13 practitioners
Practice locations: Madison, WV; Montgomery, WV; Ripley, WV; South Charleston, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1074475Charleston Nephrology Hypertension & Transplant4825 Maccorkle Ave SW Ste a, South Charleston, WV 25309Provider-performed microscopySep 27, 2027

National Provider Directory

National Provider Directory

Locations

510 Main St
Belpre, OH 45714
Phone (304) 400-4700

55 Hubert HL Rd
Chapmanville, WA 25508
Phone (304) 414-2850

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

122 Pinnell St
Bldg 6
Ripley, WV 25271
Phone (304) 400-4700

4610 Kanawha Ave SW
Ste 402
South Charleston, WV 25309
Phone (304) 400-4700

4825 Maccorkle Ave SW
Ste A
South Charleston, WV 25309
Phone (304) 400-4700

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1003017823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW",
            "address_2": "SUITE A",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-400-4700",
            "fax_number": "304-693-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW",
            "address_2": "SUITE A",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-400-4700",
            "fax_number": "304-693-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "ZANABLI",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "RAHMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "304-400-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WV",
            "license": "22697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010603",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "001953144",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.