Organization Active NPI

Med Surg Physician Group, Inc.

  • Specialist
  • Beckley, WV
National Provider Identifier
1063943678
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21042 Issued in WV
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
O20170607001206 WV Part B Supplier - Clinic/Group Practice 2365710761 Receives reassigned benefits from 5 practitioners
Practice locations: Beckley, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0678840Med Surg Physician Group Inc1902 Harper Road, Suite Abc, Beckley, WV 25801Certificate of waiverOct 22, 2027

National Provider Directory

National Provider Directory

Locations

1902 Harper Rd
Ste Abc
Beckley, WV 25801
Phone (304) 253-3000

Interoperability endpoints

  • FHIR API: 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.

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

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.

Verify at the official NPI Registry.