Organization Active NPI

Khoury Surgical Group, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Wheeling, WV
National Provider Identifier
1164572699
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
KHOURY SURGICAL GROUP, INC.
Practice address
20 Medical Park
Suite 203
Wheeling, WV 26003-6390
Phone
(304) 233-2455
Fax
(304) 233-6073
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Dr. Rajai T Khoury, MD
Title
President
Phone
(304) 233-2455

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

20 Medical Park
Suite 203
Wheeling, WV 26003-6390

Mailing address

PO Box 6780
Wheeling, WV 26003-0918
Phone (304) 233-2455

Other identifiers 2

IdentifierTypeStateIssuer
3810003359MedicaidWV
0492766MedicaidOH

National Provider Directory

National Provider Directory

Locations

4100 Johnson Rd
Ste 202
Steubenville, OH 43952
Phone (740) 346-2216

845 Commerce St
Wellsburg, WV 26070

2000 Eoff St
Bldg Vascular
Wheeling, WV 26003

20 Medical Park
Ste 203
Wheeling, WV 26003
Phone (304) 234-8942

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1164572699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6780",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030918",
            "telephone_number": "304-233-2455",
            "fax_number": "304-233-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL PARK",
            "address_2": "SUITE 203",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036390",
            "telephone_number": "304-233-2455",
            "fax_number": "304-233-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHOURY SURGICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "RAJAI",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-233-2455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003359",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0492766",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.