NPIMap

Organization Active NPI

South Branch Surgical Associates Inc

  • Surgery Physician
  • Petersburg, WV
National Provider Identifier
1003980541
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
15545 Issued in WV
Legal business name
SOUTH BRANCH SURGICAL ASSOCIATES INC
Practice address
Grant Memorial Hospital
Route 55
Petersburg, WV 26847-0788
Phone
(304) 257-4331
Fax
(304) 257-2891
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Authorized official

Name
Dr. Anil K Makani, MDNPI 1619067139
Title
President
Phone
(304) 257-4331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 15545 WV Primary

Addresses

Primary practice location

Grant Memorial Hospital
Route 55
Petersburg, WV 26847-0788

Mailing address

PO Box 788
Petersburg, WV 26847-0788
Phone (304) 257-4331

Other identifiers 1

IdentifierTypeStateIssuer
0009932000MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1003980541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268470788",
            "telephone_number": "304-257-4331",
            "fax_number": "304-257-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRANT MEMORIAL HOSPITAL",
            "address_2": "ROUTE 55",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268470788",
            "telephone_number": "304-257-4331",
            "fax_number": "304-257-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BRANCH SURGICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "MAKANI",
        "authorized_official_first_name": "ANIL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-257-4331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WV",
            "license": "15545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009932000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.