NPIMap

Organization Active NPI

Wvu Medical Corporation

  • Family Medicine Physician
  • Morgantown, WV
National Provider Identifier
1164828224
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WVU MEDICAL CORPORATION
Practice address
6040 University Town Center Drive
Morgantown, WV 26501-2421
Phone
(304) 598-4800
NPI assigned
Nov 17, 2014
Last updated
Apr 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Authorized official

Name
Andrea M Rumble
Title
Provider Enrollment
Phone
(304) 285-7101

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary
Sports Medicine (Family Medicine) Physician 207QS0010X
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Urology Physician 208800000X

Addresses

Primary practice location

6040 University Town Center Drive
Morgantown, WV 26501-2421

Mailing address

PO Box 780
Morgantown, WV 26507-0780
Phone (304) 285-7100

Other names 1

  • WVU HEALTHCARE UNIVERSITY TOWN CENTRE Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000207 WV Part B Supplier - Clinic/Group Practice 1052224565 Receives reassigned benefits from 2,746 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2092989Wvu Hospitals University Town Ctr6040 University Town Centre Drive, Morgantown, WV 26501Provider-performed microscopyMar 17, 2027
51D2328190Wvu Hospitals University Town Ctr6040 University Towne Centre Drive, Morgantown, WV 26501Certificate of waiverAug 5, 2027

National Provider Directory

National Provider Directory

Locations

2345 Chesterfield Ave
Ste 302
Charleston, WV 25304
Phone (304) 720-2039

800 Grand Central Mall
Vienna, WV 26105
Phone (304) 485-3300

Practitioners & affiliated clinicians

Practitioners 126

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 126

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1164828224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7100",
            "fax_number": "304-285-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 UNIVERSITY TOWN CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265012421",
            "telephone_number": "304-598-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVU MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "RUMBLE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "304-285-7101"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WVU HEALTHCARE UNIVERSITY TOWN CENTRE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.