NPIMap

Organization Active NPI

Med Surg Physician Group, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Beckley, WV
National Provider Identifier
1083373997
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
MED SURG PHYSICIAN GROUP, INC.
Practice address
379 Stanaford Rd Ste 200
Beckley, WV 25801-3141
Phone
(304) 253-3000
Fax
(304) 929-2038
NPI assigned
Dec 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Ms. Amber Moore
Title
Office Manager
Phone
(304) 253-3000

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Health Service Clinic/Center 261QH0100X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Recovery Care Clinic/Center 261QR0800X
Substance Use Disorder Rehabilitation Hospital Unit 276400000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Psychiatric Residential Treatment Facility 323P00000X
Children's Substance Abuse Rehabilitation Facility 3245S0500X
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

379 Stanaford Rd Ste 200
Beckley, WV 25801-3141

Mailing address

1902 Harper Rd Ste Abc
Beckley, WV 25801-2642
Phone (304) 253-3000

Other names 1

  • Elena Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Locations

379 Stanaford Rd
Ste 200
Beckley, WV 25801
Phone (304) 253-3000

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

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1083373997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 STANAFORD RD STE 200",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013141",
            "telephone_number": "304-253-3000",
            "fax_number": "304-929-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED SURG PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2023-10-12",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-253-3000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elena Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 12, 2023; 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.