NPIMap

Organization Active NPI

Williamstown Medical Service, Inc.

  • Family Medicine Physician
  • Williamstown, WV
National Provider Identifier
1083767859
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
676 Issued in WV
Legal business name
WILLIAMSTOWN MEDICAL SERVICE, INC.
Practice address
501 Highland Ave
Williamstown, WV 26187-1615
Phone
(304) 375-7992
Fax
(304) 375-3762
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Russell Louis Schreiber, D.O.NPI 1770627028
Title
President
Phone
(304) 375-7992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 676 WV Primary

Addresses

Primary practice location

501 Highland Ave
Williamstown, WV 26187-1615

Mailing address

501 Highland Ave
Williamstown, WV 26187-1615
Phone (304) 375-7992

Other identifiers 2

IdentifierTypeStateIssuer
0315555MedicaidOH
0049300000MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083767859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871615",
            "telephone_number": "304-375-7992",
            "fax_number": "304-375-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HIGHLAND AVE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261871615",
            "telephone_number": "304-375-7992",
            "fax_number": "304-375-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSTOWN MEDICAL SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-375-7992",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0315555",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049300000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.