Organization Active NPI

West Virginia University Medical Corporation

  • Pediatrics Physician
  • Reedsville, WV
National Provider Identifier
1003797234
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Practice address
14 Comfort Dr
Reedsville, WV 26547-1401
Phone
(304) 864-0006
NPI assigned
Sep 12, 2025
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Justin Gibson
Title
VP of Finance
Phone
(304) 598-4256

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 176B00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

14 Comfort Dr
Reedsville, WV 26547-1401

Mailing address

PO Box 780
Morgantown, WV 26507-0780

National Provider Directory

National Provider Directory
Tax ID family
Physician Office Center Dbauha Lab204 organizations share this tax ID, including this one
Part of
Physician Office Center Dbauha Lab

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1003797234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 COMFORT DR",
            "city": "REEDSVILLE",
            "state": "WV",
            "postal_code": "265471401",
            "telephone_number": "304-864-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "304-598-4256"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.