Organization Active NPI

Mid-Ohio Valley Nephrology Association

  • Nephrology Physician
  • Vienna, WV
National Provider Identifier
1073903373
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20965 Issued in WV
Legal business name
MID-OHIO VALLEY NEPHROLOGY ASSOCIATION
Practice address
800 Grand Central Mall
Suite 9
Vienna, WV 26105-4100
Phone
(304) 834-3970
Fax
(304) 916-1871
NPI assigned
Jan 26, 2015
Last updated
Jan 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Authorized official

Name
Rabina Malik-Hamirani, M.D.NPI 1831159896
Title
Co-Owner
Phone
(304) 834-3970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 25689 WV
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X 25689 WV
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 20965 WV Primary

Addresses

Primary practice location

800 Grand Central Mall
Suite 9
Vienna, WV 26105-4100

Mailing address

800 Grand Central Mall
Suite 9
Vienna, WV 26105-4100
Phone (304) 834-3970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150617003056 WV Part B Supplier - Clinic/Group Practice 8224056445 Receives reassigned benefits from 2 practitioners
Practice locations: Vienna, WV
O20151214001936 OH Part B Supplier - Clinic/Group Practice 8224056445 Receives reassigned benefits from 2 practitioners
Practice locations: Marietta, OH

National Provider Directory

National Provider Directory
Tax ID family
Mid-Ohio Valley Nephrology Association2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

425 Matthew St
Marietta, OH 45750
Phone (304) 834-3970

425 Matthew St
Marietta, OH 45750
Phone (304) 834-3970

800 Grand Central Mall
Ste 9
Vienna, WV 26105
Phone (304) 834-3970

Practitioners & affiliated clinicians

Practitioners 3

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": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1073903373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 9",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-834-3970",
            "fax_number": "304-916-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 9",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-834-3970",
            "fax_number": "304-916-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-OHIO VALLEY NEPHROLOGY ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "MALIK-HAMIRANI",
        "authorized_official_first_name": "RABINA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "304-834-3970",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "25689",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WV",
            "license": "25689",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "WV",
            "license": "20965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.