NPIMap

Organization Active NPI

Potomac Valley Hospital of W VA , Inc

  • Internal Medicine Physician
  • Keyser, WV
National Provider Identifier
1124842786
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
POTOMAC VALLEY HOSPITAL OF W VA , INC
Practice address
537 S Mineral St
Keyser, WV 26726-2936
Phone
(304) 788-1274
Fax
(304) 788-5154
NPI assigned
Nov 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Mark G Boucot
Title
President/Ceo
Phone
(304) 597-3510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

537 S Mineral St
Keyser, WV 26726-2936

Mailing address

100 Pin Oak LN
Keyser, WV 26726-5908
Phone (304) 597-3510

National Provider Directory

National Provider Directory
Tax ID family
Potomac Valley Hospital of WV Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1124842786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PIN OAK LN",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267265908",
            "telephone_number": "304-597-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 S MINERAL ST",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267262936",
            "telephone_number": "304-788-1274",
            "fax_number": "304-788-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC VALLEY HOSPITAL OF W VA , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "BOUCOT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "304-597-3510"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keyser, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.