Individual provider Active NPI

Rajiv K. Jain, DO

  • Family Medicine Physician
  • Huntington, WV
National Provider Identifier
1124008917
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1666 Issued in WV
Practice address
2900 1St Ave
Huntington, WV 25702-1241
Phone
(304) 399-7484
Fax
(304) 399-7579
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1666 WV Primary
Family Medicine Physician 207Q00000X 34.007367 OH

Addresses

Primary practice location

2900 1St Ave
Huntington, WV 25702-1241

Mailing address

PO Box 88
5 E Alvon Road Suite 7
White Sulphur Springs, WV 24986-2373
Phone (304) 536-5030

Other identifiers 6

IdentifierTypeStateIssuer
3002051000MedicaidWV
1057639OtherCOMPNET
2246724MedicaidOH
63154600OtherWVBLACK LUNG
3232099OtherWVCIGNA
64040496MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1666WVMDMetabolic Nutrition Registered Dietitian
34.007367OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Physicians Inc CurrentSince May 1, 2022 Accepting new patients
St. Mary'S Medical Management Highlawn Lab Past Accepting new patients
Ohio Valley Physicians Inc Family Medicine Past Accepting new patients

Locations

6500 Highway 645
Ste 120
Inez, KY 41224
Phone (606) 534-4002

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1124008917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "address_2": "5 E ALVON ROAD SUITE 7",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249862373",
            "telephone_number": "304-536-5030",
            "fax_number": "304-536-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 1ST AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-399-7484",
            "fax_number": "304-399-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "RAJIV",
        "middle_name": "K.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1666",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.007367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3002051000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPNET",
            "identifier": "1057639",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2246724",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "63154600",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3232099",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64040496",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.