Organization Active NPI

Russell Biundo MD Inc

  • Physical Medicine & Rehabilitation Physician
  • Morgantown, WV
National Provider Identifier
1174584353
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
RUSSELL BIUNDO MD INC
Practice address
1160 Van Voorhis Rd
Morgantown, WV 26505-3437
Phone
(304) 598-1122
Fax
(304) 598-1124
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Authorized official

Name
Russell Biundo, MD
Title
President
Phone
(304) 598-1122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X WV Primary

Addresses

Primary practice location

1160 Van Voorhis Rd
Morgantown, WV 26505-3437

Mailing address

1160 Van Voorhis Rd
Morgantown, WV 26505-3437
Phone (304) 598-1122

Other identifiers 6

IdentifierTypeStateIssuer
784081100OtherMDMARYLAND MEDICAID
0016737660001OtherPAPENNSYLVANIA MEDICAID
1424801OtherUMWA
198177OtherFEDERAL BLACK LUNG
001707270OtherMT STATE BLUE CROSS BLUE
CG6938OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1160 Van Voorhis Rd
Ste 110
Morgantown, WV 26505

1160 Van Voorhis Rd
Rm 110
Morgantown, WV 26505

63 Wharf St
Ste 75
Morgantown, WV 26501
Phone (304) 296-4767

Practitioners & affiliated clinicians

Practitioners 5

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": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1174584353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VAN VOORHIS RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053437",
            "telephone_number": "304-598-1122",
            "fax_number": "304-598-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VAN VOORHIS RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053437",
            "telephone_number": "304-598-1122",
            "fax_number": "304-598-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL BIUNDO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "BIUNDO",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-598-1122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND MEDICAID",
            "identifier": "784081100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA MEDICAID",
            "identifier": "0016737660001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1424801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "198177",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT STATE BLUE CROSS BLUE",
            "identifier": "001707270",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG6938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 21, 2012; 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.