Individual provider Active NPI

Chandra Mohan Kumar, MD

  • Allergy & Immunology Physician
  • Charleston, WV
National Provider Identifier
1164536264
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
11875 Issued in WV
Practice address
208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone
(304) 343-4300
Fax
(304) 343-5473
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 11875 WV Primary

Addresses

Primary practice location

208 Maccorkle Ave SE
Charleston, WV 25314-1160

Mailing address

208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone (304) 343-4300

Other practice location 1

730 Woodside Rd
Redwood City, CA 94061-3749
Phone (650) 368-8800

Other identifiers 1

IdentifierTypeStateIssuer
0112177000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041109000312 WV Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 0941262737 Reassigns benefits to 1 organization
I20180913000946 CA Practitioner - Allergy/Immunology 0941262737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WV Asthma and Allergy Centers Inc 8 clinicians

Practice addresses (Care Compare)

208 Maccorkle Ave SE
Charleston, WV 25314-1160
Phone 304343430099

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WV Asthma and Allergy Centers, Inc. Allergy & Immunology CurrentSince Jun 1, 2008 Accepting new patients
WV Asthma and Allergy Centers, Inc. Allergy & Immunology CurrentSince Mar 15, 2020 Accepting new patients
WV Asthma and Allergy Centers, Inc. Allergy & Immunology Current Accepting new patients
Family Asthma and Allergy Center P.C. Allergy & Immunology CurrentSince Sep 20, 2018 Accepting new patients
WV Asthma and Allergy Centers, Inc. Allergy & Immunology Past Accepting new patients
WV Asthma and Allergy Centers, Inc Allergy & Immunology Past Accepting new patients
WV Asthma & Allergy Centers, Inc. Allergy & Immunology Past Accepting new patients

Locations

730 Woodside Rd
Redwood City, CA 94061
Phone (650) 368-8800

246 George St
Beckley, WV 25801
Phone (304) 253-7100

208 Maccorkle Ave SE
Charleston, WV 25314
Phone (304) 343-4300

100 Main Ave
Logan, WV 25601
Phone (304) 831-6700

118 Nick Savas Dr
Logan, WV 25601
Phone (304) 752-4045

418 Grand Park Dr
Ste 326
Parkersburg, WV 26105
Phone (304) 422-1400

598 Church St S
#A
Ripley, WV 25271
Phone (304) 372-3033

Organizations & group practices 7

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1164536264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141160",
            "telephone_number": "304-343-4300",
            "fax_number": "304-343-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141160",
            "telephone_number": "304-343-4300",
            "fax_number": "304-343-5473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Woodside Rd",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940613749",
            "country_code": "US",
            "telephone_number": "650-368-8800",
            "fax_number": "650-368-8809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "CHANDRA",
        "middle_name": "MOHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WV",
            "license": "11875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112177000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.