NPIMap

Organization Active NPI

Pocahontas Memorial Hospital

  • Emergency Medicine Physician
  • Buckeye, WV
National Provider Identifier
1104020163
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
POCAHONTAS MEMORIAL HOSPITAL
Practice address
150 Duncan Rd
Buckeye, WV 24924-9037
Phone
(304) 799-7400
Fax
(304) 799-6636
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Barbara Lay
Title
Ceo
Phone
(304) 799-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

150 Duncan Rd
Buckeye, WV 24924-9037

Mailing address

150 Duncan Rd
Buckeye, WV 24924-9037
Phone (304) 799-7400

Other identifiers 1

IdentifierTypeStateIssuer
3810000535MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Pocahontas Memorial Hos9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

150 Duncan Rd
Buckeye, WV 24924
Phone (304) 799-7400

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1104020163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 DUNCAN RD",
            "city": "BUCKEYE",
            "state": "WV",
            "postal_code": "249249037",
            "telephone_number": "304-799-7400",
            "fax_number": "304-799-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DUNCAN RD",
            "city": "BUCKEYE",
            "state": "WV",
            "postal_code": "249249037",
            "telephone_number": "304-799-7400",
            "fax_number": "304-799-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCAHONTAS MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "LAY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-799-7400"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000535",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.