Organization Active NPI

Alfredo C Velasquez MD PLLC

  • Specialist
  • Charleston, WV
National Provider Identifier
1194028373
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9189 Issued in WV
Legal business name
ALFREDO C VELASQUEZ MD PLLC
Practice address
209 Washington St W
Charleston, WV 25302-2345
Phone
(304) 345-3378
Fax
(304) 344-4420
NPI assigned
Dec 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Mr. Alfredo C Velasquez, MD
Title
Doctor
Phone
(304) 345-3378

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 9189 WV Primary

Addresses

Primary practice location

209 Washington St W
Charleston, WV 25302-2345

Mailing address

209 Washington St W
Charleston, WV 25302-2345
Phone (304) 345-3378

Other identifiers 1

IdentifierTypeStateIssuer
0089466000MedicaidWV

National Provider Directory

National Provider Directory

Locations

209 Washington St W
#100
Charleston, WV 25302
Phone (304) 344-8000

22 W 2nd Ave
Williamson, WV 25661
Phone (304) 235-0222

Practitioners & affiliated clinicians

Practitioners 2

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": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1194028373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WASHINGTON ST W",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022345",
            "telephone_number": "304-345-3378",
            "fax_number": "304-344-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WASHINGTON ST W",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022345",
            "telephone_number": "304-345-3378",
            "fax_number": "304-344-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFREDO C VELASQUEZ MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "304-345-3378",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "9189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089466000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.