NPIMap

Individual provider Active NPI

Mohammad Imani, DPM

  • Foot & Ankle Surgery Podiatrist
  • Charleston, WV
National Provider Identifier
1134183643
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
249 Issued in WV
Practice address
4813 Maccorkle Ave SE
Charleston, WV 25304-1948
Phone
(304) 925-3338
Fax
(304) 925-3365
NPI assigned
Apr 12, 2006
Last updated
Jul 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 249 WV Primary

Addresses

Primary practice location

4813 Maccorkle Ave SE
Charleston, WV 25304-1948

Mailing address

4813 Maccorkle Ave SE
Charleston, WV 25304-1948
Phone (304) 925-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060927000349 WV Practitioner - Podiatry 8325043284 Reassigns benefits to 2 organizations
Practice locations: Charleston, WV
O20100930033872 WV DME Supplier - Physician - Podiatry 5496963951 Practice locations: Charleston, WV

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Development Co.Group PAC ID 4183527476, shared by 9 NPIs, 65 clinicians

Practice addresses (Care Compare)

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-4444

4813 Maccorkle Ave SE
Charleston, WV 25304-1948
Phone (304) 925-3338

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue338
Removal of nail tissue106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Development Co CurrentSince Jan 1, 2022 Accepting new patients
Hospital Development Co CurrentSince Jan 1, 2022 Accepting new patients
Hospital Development Co CurrentSince Dec 31, 2025 Accepting new patients
Hospital Development Co Current Accepting new patients
Hospital Development Co Current Accepting new patients

Locations

200 Hospital Dr
Spencer, WV 25276
Phone (304) 927-4444

Interoperability endpoints

  • Direct secure messaging: doctor@mimanimd.direct.emds.com

Organizations & group practices 5

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

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1134183643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4813 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041948",
            "telephone_number": "304-925-3338",
            "fax_number": "304-925-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041948",
            "telephone_number": "304-925-3338",
            "fax_number": "304-925-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMANI",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WV",
            "license": "249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.