Active NPI
Srini Govindan, MD
- Specialist
- Wheeling, WV
National Provider Identifier
1013919877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 9751
- Practice address
- 40 Medical Park
Suite 500
Wheeling, WV 26003 - Phone
- (304) 242-2503
- Fax
- (304) 242-2682
- NPI assigned
- Aug 11, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 9751 | WV | Primary |
Addresses
Primary practice location
40 Medical Park
Suite 500
Wheeling, WV 26003
Mailing address
40 Medical Park
Suite 500
Wheeling, WV 26003
Phone (304) 242-2503
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9751 | Other | WV | STATE LICENSE NUMBER |
| 0090961000 | Medicaid | WV | |
| 0399064 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9751 | WV | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wheeling Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Wheeling, WV
- NPI 1922282581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1013919877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 MEDICAL PARK",
"address_2": "SUITE 500",
"city": "WHEELING",
"state": "WV",
"postal_code": "26003",
"telephone_number": "304-242-2503",
"fax_number": "304-242-2682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MEDICAL PARK",
"address_2": "SUITE 500",
"city": "WHEELING",
"state": "WV",
"postal_code": "26003",
"telephone_number": "304-242-2503",
"fax_number": "304-242-2682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOVINDAN",
"first_name": "SRINI",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WV",
"license": "9751",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "9751",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0090961000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0399064",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheeling, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.