Individual provider Active NPI

Thomas F Wilshire III, D.O.

  • Family Medicine Physician
  • Grafton, WV
National Provider Identifier
1033167630
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1865 Issued in WV
Practice address
1 Hospital PLZ
Grafton, WV 26354-1283
Phone
(304) 265-7406
NPI assigned
May 5, 2006
Last updated
Mar 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1865 WV Primary

Addresses

Primary practice location

1 Hospital PLZ
Grafton, WV 26354-1283

Mailing address

1893 Grafton Rd
Morgantown, WV 26508-3817
Phone (304) 296-3741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000282 WV Practitioner - Family Practice 7810936382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grafton City Hospital, Inc.Group PAC ID 7719897263, shared by 4 NPIs, 17 clinicians

Practice addresses (Care Compare)

1 Hospital PLZ
Grafton, WV 26354-1283
Phone (304) 265-7406

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1865WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grafton City Hospital Inc Current Accepting new patients
Grafton City Hospital Inc CurrentSince Feb 4, 2014 Accepting new patients
Grafton City Hospital Inc CurrentSince Feb 4, 2014 Accepting new patients
Russell Biundo MD Inc Past Accepting new patients

Locations

1 Hospital Plz
Grafton, WV 26354
Phone (304) 265-0400

500 Market St
Grafton, WV 26354
Phone (304) 265-0400

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/grafton-33215f04

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1033167630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 GRAFTON RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265083817",
            "telephone_number": "304-296-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263541283",
            "telephone_number": "304-265-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSHIRE",
        "first_name": "THOMAS",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WV

Sources for this page

Verify at the official NPI Registry.