NPIMap

Organization Active NPI

Camden Clark Memorial Hospital Corporation

  • General Practice Physician
  • Parkersburg, WV
National Provider Identifier
1104063098
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CAMDEN CLARK MEMORIAL HOSPITAL CORPORATION
Practice address
800 Garfield Ave
Parkersburg, WV 26101-5340
Phone
(304) 424-2111
NPI assigned
Jan 14, 2009
Last updated
Jan 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Authorized official

Name
Allen R Butcher
Title
Vice President of Finance
Phone
(304) 424-2202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

800 Garfield Ave
Parkersburg, WV 26101-5340

Mailing address

800 Garfield Ave
Parkersburg, WV 26101-5340

Other identifiers 1

IdentifierTypeStateIssuer
0001155003MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Camden Clark Memorial H19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1104063098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015340",
            "telephone_number": "304-424-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN CLARK MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "BUTCHER",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "304-424-2202"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001155003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.