Charleston Internal Medicine Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CHARLESTON INTERNAL MEDICINE INC

Practice address

3701 Maccorkle Ave SE
Charleston, WV 25304-1525

Phone

(304) 720-2345

Fax

(304) 720-2347

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Roy Thomas Bowden III, DO

Title

President and Owner

Phone

(304) 720-2345

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1033206263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041525",
            "telephone_number": "304-720-2345",
            "fax_number": "304-720-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041525",
            "telephone_number": "304-720-2345",
            "fax_number": "304-720-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON INTERNAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "304-720-2345",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004289",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charleston Heart Specialists, PLLC
• Charleston Hospital Inc.
• Charleston Hospital, Inc.
• Charleston Hospital, Inc.
• Charleston Infusion Services, LLC
• Charleston Internal Medicine, Inc
• Charleston Medical Associates, PLLC
• Charleston Medical Center Pharmacy
• Charleston Medical Center, Inc.
• Charleston Medical Supplies

• All providers in Charleston, WV
• Internal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.