NPIMap

Organization Active NPI

West Virginia University Medical Corporation

  • Family Medicine Physician
  • Martinsburg, WV
National Provider Identifier
1174404305
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Practice address
155 Health Care LN
Martinsburg, WV 25401-4008
Phone
(304) 596-6911
NPI assigned
Sep 12, 2025
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Justin Gibson
Title
VP of Finance
Phone
(304) 598-4256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

155 Health Care LN
Martinsburg, WV 25401-4008

Mailing address

PO Box 780
Morgantown, WV 26507-0780

National Provider Directory

National Provider Directory
Tax ID family
Physician Office Center Dbauha Lab204 organizations share this tax ID, including this one
Part of
Physician Office Center Dbauha Lab

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1174404305",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HEALTH CARE LN",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254014008",
            "telephone_number": "304-596-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "304-598-4256"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.