NPIMap

Organization Active NPI

Raleigh General Hospital LLC

Doing business as Advanced Urology

  • Internal Medicine Physician
  • Beckley, WV
National Provider Identifier
1114475746
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RALEIGH GENERAL HOSPITAL LLC
Doing business as
Advanced Urology
Raleigh Cardiac
Raleigh Cardiac Center2 more in Other names
Practice address
1717 Harper Rd
Suite G
Beckley, WV 25801-3373
Phone
(304) 461-3909
Fax
(304) 461-3916
NPI assigned
Sep 12, 2016
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Interventional Cardiology Physician 207RI0011X
Surgery Physician 208600000X
Urology Physician 208800000X

Addresses

Primary practice location

1717 Harper Rd
Suite G
Beckley, WV 25801-3373

Mailing address

PO Box 5538
Beckley, WV 25801-7507
Phone (304) 461-3909

Other names 5

  • Advanced Urology Doing business as
  • Raleigh Cardiac Doing business as
  • Raleigh Cardiac Center Doing business as
  • Raleigh General Surgery Doing business as
  • Raleigh Heart and Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040914001132 WV Part B Supplier - Clinic/Group Practice 6103735154 Receives reassigned benefits from 67 practitioners
18 other NPIs on this enrollment
Practice locations: Beckley, WV

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Raleigh General Hospita15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

1007 S Oakwood Ave
Beckley, WV 25801
Phone (304) 250-0004

1007 S Oakwood Ave
Ste 100B
Beckley, WV 25801
Phone (304) 461-3165

1717 Harper Rd
Ste 2E
Beckley, WV 25801

1717 Harper Rd
Ste 2G
Beckley, WV 25801

1717 Harper Rd
Ste A
Beckley, WV 25801
Phone (304) 461-3879

1717 Harper Rd
Ste C
Beckley, WV 25801
Phone (304) 461-3753

1717 Harper Rd
Ste Ef
Beckley, WV 25801
Phone (304) 256-4100

198 Carriage Dr
Beckley, WV 25801
Phone (304) 256-4348

2962 Robert C Byrd Dr
Beckley, WV 25801
Phone (304) 254-3022

Practitioners & affiliated clinicians

Practitioners 68

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 68

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1114475746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5538",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258017507",
            "telephone_number": "304-461-3909",
            "fax_number": "304-461-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 HARPER RD",
            "address_2": "SUITE G",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013373",
            "telephone_number": "304-461-3909",
            "fax_number": "304-461-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH GENERAL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Urology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raleigh Cardiac",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raleigh Cardiac Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raleigh Cardiac Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raleigh General Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raleigh Heart and Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.