Petaiah Mohan, M.D

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

18400 Issued in WV

Practice address

194 Carriage Dr
Beckley, WV 25801-2804

Phone

(304) 255-6051

Fax

(304) 255-6051

NPI assigned

Oct 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: petaiah.mohan@wvafn.hcadirect.net

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.

• Appalachian Mountains Medical, LLC

  • Emergency Medicine Physician
  • Welch, WV
  • NPI 1881023117
  Medicare reassignment NPD
• Appalachian Regional Healthcare, Inc

  • Family Medicine Physician
  • Beckley, WV
  • NPI 1477510162
  Medicare reassignment NPD
• Raleigh General Hospital LLC

  • Internal Medicine Physician
  • Beckley, WV
  • NPI 1114475746
  Medicare reassignment NPD
• Appalachian Regional Healthcare, Inc.

  • Clinical Pathology/Laboratory Medicine Physician
  • Beckley, WV
  • NPI 1417048539
  NPD
• Raleigh General Hospital LLC

  • Hospitalist Physician
  • Beckley, WV
  • NPI 1417457250
  NPD
• Appalachian Regional Healthcare, Inc

  • Community/Retail Pharmacy
  • Cumberland, KY
  • NPI 1710870811
  NPD
• Kelly Medical Services Corporation LLC

  • Emergency Medicine Physician
  • Welch, WV
  • NPI 1033154810
  NPD (past)
• Raleigh General Hospital LLC

  • General Acute Care Hospital
  • Beckley, WV
  • NPI 1629015698
  NPD (past)

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1033295324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 HARPER RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013357",
            "telephone_number": "304-255-6051",
            "fax_number": "304-255-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 CARRIAGE DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012804",
            "telephone_number": "304-255-6051",
            "fax_number": "304-255-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "PETAIAH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WV",
            "license": "18400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110044000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvette Renee Mitchell
• Jodi Mitchem
• Kimberly Mitchem
• Melissa Mitchem
• Kristy Lea Moeller
• Saraswathi Mohan, M.D.
• Shirley Moles
• Michelle Lynn Mollohan, PTA
• Monroe County Board of Education
• Monroe County Schools

• Neonatal-Perinatal Medicine Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Neonatal-Perinatal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.