Active NPI
Med Surg Physician Group, Inc.
- Specialist
- Beckley, WV
National Provider Identifier
1063943678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 21042
- Legal business name
- MED SURG PHYSICIAN GROUP, INC.
- Practice address
- 1902 Harper Rd Ste Abc
Beckley, WV 25801-2642 - Phone
- (304) 253-3000
- Fax
- (304) 929-2038
- NPI assigned
- Mar 24, 2017
- Last updated
- Sep 8, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Olu R Sangodeyi, M. D.
- Title
- Owner, Ceo
- Phone
- (304) 673-4294
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 21042 | WV | Primary |
Addresses
Primary practice location
1902 Harper Rd Ste Abc
Beckley, WV 25801-2642
Mailing address
104 Florida Ave
Beckley, WV 25801-2408
Phone (304) 673-4294
Other practice location 1
158 Hinton Byp
Hinton, WV 25951-9184
Phone (304) 309-4143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0678840 | Med Surg Physician Group Inc | Certificate of waiver | Oct 22, 2027 |
National Provider Directory
National Provider DirectoryLocations
1902 Harper Rd
Ste Abc
Beckley, WV 25801
Phone (304) 253-3000
Interoperability endpoints
- https://api.platform.athenahealth.com/16151/brand/2/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Counselor
- Beckley, WV
- NPI 1508406612
-
- Family Nurse Practitioner
- Beckley, WV
- NPI 1710113022
-
- Family Nurse Practitioner
- Beckley, WV
- NPI 1083604441
-
- Surgery Physician
- Beckley, WV
- NPI 1487651717
-
- Emergency Medicine Physician
- Bluefield, WV
- NPI 1942221825
-
- Addiction (Substance Use Disorder) Counselor
- Beckley, WV
- NPI 1013490838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788825600000",
"number": "1063943678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 FLORIDA AVE",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012408",
"telephone_number": "304-673-4294",
"fax_number": "304-255-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1902 HARPER RD STE ABC",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012642",
"telephone_number": "304-253-3000",
"fax_number": "304-929-2038"
}
],
"practiceLocations": [
{
"address_1": "158 Hinton Byp",
"address_purpose": "LOCATION",
"city": "Hinton",
"state": "WV",
"postal_code": "259519184",
"country_code": "US",
"telephone_number": "304-309-4143",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MED SURG PHYSICIAN GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-24",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A",
"authorized_official_last_name": "SANGODEYI",
"authorized_official_first_name": "OLU",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER, CEO",
"authorized_official_telephone_number": "304-673-4294",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M. D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WV",
"license": "21042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beckley, WV
- Tosha Marie Meadows
- Stacy Nicole Means, PRSS
- Mebrahtom Tesfai PLLC
- Med Surg Eye Care Inc
- Med Surg Eye Care Inc
- Med Surg Physician Group, Inc. (Elena Behavioral Health)
- Medexpress Primary Care West Virginia, Inc. (MedExpress Primary Care - Beckley)
- Medexpress Urgent Care, PLLC - Beckley
- Ina Louise Medina
- Rhoneka Medley
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.