Individual provider Active NPI

Achuta Ram Aynampudi, MD

  • Psychiatry Physician
  • Fairmont, WV
National Provider Identifier
1124434550
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
28061 Issued in WV
Practice address
100 Stoney Hill Rd
Fairmont, WV 26554
Phone
(304) 285-5400
Fax
(304) 285-5401
NPI assigned
Jul 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 28061 WV Primary

Addresses

Primary practice location

100 Stoney Hill Rd
Fairmont, WV 26554

Mailing address

100 Stoney Hill Rd
Fairmont, WV 26554-1589
Phone (304) 285-5400

Other practice location 1

3601 4th St
Ms 8103
Lubbock, TX 79430-0002
Phone (806) 743-6162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180907000419 WV Practitioner - Psychiatry 2264730498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William R Sharpe Jr Hospital 19 clinicians

Practice addresses (Care Compare)

936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone (304) 269-1210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28061WVMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William R Sharpe Jr Hospital CurrentSince Dec 9, 2019 Accepting new patients
William R. Sharpe, Jr. Hospital CurrentSince Dec 9, 2019 Accepting new patients

Locations

936 Sharpe Hospital Rd
Weston, WV 26452
Phone (304) 269-1210

Organizations & group practices 2

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1124434550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STONEY HILL RD",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541589",
            "telephone_number": "304-285-5400",
            "fax_number": "304-285-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STONEY HILL RD",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-285-5400",
            "fax_number": "304-285-5401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_2": "MS 8103",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-6162",
            "fax_number": "806-743-1262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYNAMPUDI",
        "first_name": "ACHUTA",
        "middle_name": "RAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "28061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.