Organization Active NPI

Allegheny Emergency Physicians LLP

  • Emergency Medicine Physician
  • Fairmont, WV
National Provider Identifier
1184925539
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ALLEGHENY EMERGENCY PHYSICIANS LLP
Practice address
1325 Locust Ave
Fairmont, WV 26554-1435
Phone
(304) 367-7100
Fax
(304) 367-7167
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Dr. Derik K King, MD
Title
LLP Managing Partner
Phone
(337) 609-1221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1325 Locust Ave
Fairmont, WV 26554-1435

Mailing address

75 Remit Dr # 1122
Chicago, IL 60675-1122
Phone (800) 701-3381

Other identifiers 2

IdentifierTypeStateIssuer
1184925539MedicaidVA
3810019082MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1184925539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DR # 1122",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751122",
            "telephone_number": "800-701-3381",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541435",
            "telephone_number": "304-367-7100",
            "fax_number": "304-367-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGHENY EMERGENCY PHYSICIANS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DERIK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LLP MANAGING PARTNER",
        "authorized_official_telephone_number": "337-609-1221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184925539",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019082",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.