Active NPI
Terry L Stake, M.D.
- Diagnostic Radiology Physician
- Wheeling, WV
National Provider Identifier
1023085552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 14313
- Practice address
- 1 Medical Park
Wheeling, WV 26003-6379 - Phone
- (304) 243-3270
- NPI assigned
- Mar 3, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 14313 | WV | Primary |
Addresses
Primary practice location
1 Medical Park
Wheeling, WV 26003-6379
Mailing address
PO Box 5307
Lima, OH 45802-5307
Phone (419) 224-5707
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300117903 | Other | WV | RAILROAD MEDICARE |
| 0117198000 | Medicaid | WV | |
| 000864293 | Other | WV | MT STATE BCBS |
| 300040909 | Other | OH | RAILROAD MEDICARE |
| 14313A | Other | HEALTH PLAN OF UPPER OH V | |
| 0222011 | 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 |
|---|---|---|---|
| 14313 | WV | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310083200000",
"number": "1023085552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5307",
"city": "LIMA",
"state": "OH",
"postal_code": "458025307",
"telephone_number": "419-224-5707",
"fax_number": "419-229-0040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK",
"city": "WHEELING",
"state": "WV",
"postal_code": "260036379",
"telephone_number": "304-243-3270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAKE",
"first_name": "TERRY",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2011-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WV",
"license": "14313",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300117903",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0117198000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MT STATE BCBS",
"identifier": "000864293",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300040909",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF UPPER OH V",
"identifier": "14313A",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0222011",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheeling, WV
- St. John'S/St. Vincent'S Home for Children, Inc
- St. John'S/St. Vincents'S Home for Children, Inc.
- St. John'S/St.Vincent'S Home for Children, Inc.
- Carla Jo St. Myers, FNP-BC
- Charles Henry Staab III, MD
- Stacie Morgan Starkey
- Valery Lynne Staskey, TSW
- Tonda Marie Stauffer, PA-C
- Joshua Steed
- Katherine Joan Steele, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.