NPIMap

Organization Active NPI

Charleston Surgical Hospital, LLC

Doing business as Charleston Surgical Hospital

  • General Acute Care Hospital
  • Charleston, WV
National Provider Identifier
1104904143
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
92 Issued in WV
Legal business name
CHARLESTON SURGICAL HOSPITAL, LLC
Doing business as
Charleston Surgical Hospital
Practice address
1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone
(304) 353-0319
Fax
(304) 353-0215
NPI assigned
Nov 1, 2006
Last updated
Jun 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

Name
Christina Arvon
Title
Ceo
Phone
(304) 343-4371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 92 WV Primary

Addresses

Primary practice location

1306 Kanawha Blvd E
Charleston, WV 25301-3001

Mailing address

1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 353-0319

Other identifiers 1

IdentifierTypeStateIssuer
0001157001MedicaidWV

Other names 1

  • Charleston Surgical Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518000885 WV Part B Supplier - Clinic/Group Practice 6800887092 Receives reassigned benefits from 37 practitioners
Practice locations: Charleston, WV

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17503/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/charles-8f0482a8

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1104904143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013001",
            "telephone_number": "304-353-0319",
            "fax_number": "304-353-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013001",
            "telephone_number": "304-353-0319",
            "fax_number": "304-353-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "ARVON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-343-4371"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WV",
            "license": "92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001157001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charleston Surgical Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.