Dr. Rick L Houdersheldt, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

789 Issued in WV

Legal business name

DR. RICK L HOUDERSHELDT, INC

Practice address

3705 Teays Valley Rd
Suite 202
Hurricane, WV 25526-8757

Phone

(304) 757-6990

Fax

(304) 757-0912

NPI assigned

Aug 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rick L Houdersheldt, DO

Title

Ceo

Phone

(304) 757-6990

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1003072398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 TEAYS VALLEY RD",
            "address_2": "SUITE 202",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268757",
            "telephone_number": "304-757-6990",
            "fax_number": "304-757-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 TEAYS VALLEY RD",
            "address_2": "SUITE 202",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268757",
            "telephone_number": "304-757-6990",
            "fax_number": "304-757-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RICK L HOUDERSHELDT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "HOUDERSHELDT",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-757-6990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084490000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Primary Care Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.