NPIMap

Organization Active NPI

United Hospital Center, Inc.

  • Family Medicine Physician
  • White Hall, WV
National Provider Identifier
1194269589
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNITED HOSPITAL CENTER, INC.
Doing business as
UHC-Whitehall Medical
Practice address
177 Middletown Rd Ste 1
White Hall, WV 26554-8254
Phone
(304) 363-6600
Fax
(304) 333-5201
NPI assigned
Dec 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Authorized official

Name
Michael Tillman
Title
Ceo
Phone
(681) 342-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

177 Middletown Rd Ste 1
White Hall, WV 26554-8254

Mailing address

527 Medical Park Dr Ste 400
Bridgeport, WV 26330-9010
Phone (681) 342-3500

Other names 1

  • UHC-Whitehall Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000802 WV Part B Supplier - Clinic/Group Practice 8123936010 Receives reassigned benefits from 473 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Hall, WV; Weston, WV; Summersville, WV; Nutter Fort, WV; Grafton, WV; Glenville, WV; Fairmont, WV; Elkins, WV…

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

Locations

527 Medical Park Dr
Ste 400
Bridgeport, WV 26330
Phone (681) 342-1610

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

NPI Registry JSON

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1194269589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 400",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3500",
            "fax_number": "681-342-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 MIDDLETOWN RD STE 1",
            "city": "WHITE HALL",
            "state": "WV",
            "postal_code": "265548254",
            "telephone_number": "304-363-6600",
            "fax_number": "304-333-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HOSPITAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "681-342-1000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UHC-Whitehall Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Hall, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.