Organization Active NPI

Geoffrey R. Cousins, MD, PLLC

  • Specialist
  • Charleston, WV
National Provider Identifier
1093988545
Registry record updated Sep 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21957 Issued in WV
Legal business name
GEOFFREY R. COUSINS, MD, PLLC
Practice address
2345 Chesterfield Ave
Suite 304
Charleston, WV 25304-1062
Phone
(304) 720-2244
Fax
(304) 720-2245
NPI assigned
Apr 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2008

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

Authorized official

Name
Geoffrey R Cousins, MD
Title
Owner
Phone
(304) 720-2244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 21957 WV Primary

Addresses

Primary practice location

2345 Chesterfield Ave
Suite 304
Charleston, WV 25304-1062

Mailing address

PO Box 4695
Charleston, WV 25364-4695
Phone (304) 720-2244

Other identifiers 2

IdentifierTypeStateIssuer
3810011619MedicaidWV
002022475OtherWVBC/BS

National Provider Directory

National Provider Directory

Locations

2345 Chesterfield Ave
Ste 304
Charleston, WV 25304
Phone (304) 352-2112

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220313600000",
    "number": "1093988545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4695",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253644695",
            "telephone_number": "304-720-2244",
            "fax_number": "304-720-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 CHESTERFIELD AVE",
            "address_2": "SUITE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041062",
            "telephone_number": "304-720-2244",
            "fax_number": "304-720-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEOFFREY R. COUSINS, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-09-02",
        "status": "A",
        "authorized_official_last_name": "COUSINS",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-720-2244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "21957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011619",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "002022475",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; 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.