NPIMap

Organization Active NPI

Wvuh Cheat Lake Physicians

  • Multi-Specialty Clinic/Center
  • Morgantown, WV
National Provider Identifier
1033254149
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WVUH CHEAT LAKE PHYSICIANS
Practice address
1 Medical Center Dr
Morgantown, WV 26507-1127
Phone
(304) 598-4032
Fax
(304) 598-4143
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bruce Bowman McClymonds
Title
Administrator
Phone
(304) 598-4032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X WV Primary

Addresses

Primary practice location

1 Medical Center Dr
Morgantown, WV 26507-1127

Mailing address

PO Box 1127
Morgantown, WV 26507-1127
Phone (304) 598-4032

Other identifiers 1

IdentifierTypeStateIssuer
3810001961MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
West Virginia University Hospitals Inc37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033254149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1127",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071127",
            "telephone_number": "304-598-4032",
            "fax_number": "304-598-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071127",
            "telephone_number": "304-598-4032",
            "fax_number": "304-598-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVUH CHEAT LAKE PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLYMONDS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "BOWMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "304-598-4032",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001961",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

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

Verify at the official NPI Registry.