NPIMap

Organization Active NPI

WV Asthma and Allergy Centers, Inc.

  • Allergy & Immunology Physician
  • Logan, WV
National Provider Identifier
1003091307
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
WV ASTHMA AND ALLERGY CENTERS, INC.
Practice address
118 Nick Savas Dr
Logan, WV 25601-3468
Phone
(304) 831-6700
Fax
(304) 831-6701
NPI assigned
Jan 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Mr. Jason C Trusty
Title
Administrator
Phone
(304) 343-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

118 Nick Savas Dr
Logan, WV 25601-3468

Mailing address

208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone (304) 343-4300

Other identifiers 1

IdentifierTypeStateIssuer
3810011961MedicaidWV

Other names 2

  • Asthma & Allergy Center Doing business as
  • Asthma and Allergy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080514000183 WV Part B Supplier - Clinic/Group Practice 8527137728 Receives reassigned benefits from 21 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beckley, WV; Charleston, WV; Logan, WV; Parkersburg, WV; Ripley, WV

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

208 Maccorkle Ave SE
Charleston, WV 25314
Phone (304) 343-4300

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1003091307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141160",
            "telephone_number": "304-343-4300",
            "fax_number": "304-343-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NICK SAVAS DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013468",
            "telephone_number": "304-831-6700",
            "fax_number": "304-831-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV ASTHMA AND ALLERGY CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "TRUSTY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "304-343-4300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011961",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asthma & Allergy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Asthma and Allergy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.