NPIMap

Organization Active NPI

Main Street Medical Center, PLLC

  • Pediatrics Physician
  • Ripley, WV
National Provider Identifier
1205036738
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2013 Issued in WV
Legal business name
MAIN STREET MEDICAL CENTER, PLLC
Practice address
619 Main St W
Ripley, WV 25271-1107
Phone
(304) 372-8088
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Authorized official

Name
Debbie Oneil
Title
Office Manager
Phone
(304) 372-8088

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 2013 WV
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 2013 WV Primary

Addresses

Primary practice location

619 Main St W
Ripley, WV 25271-1107

Mailing address

619 Main St W
Ripley, WV 25271-1107
Phone (304) 372-8088

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1205036738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 MAIN ST W",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252711107",
            "telephone_number": "304-372-8088",
            "fax_number": "304-372-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 MAIN ST W",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252711107",
            "telephone_number": "304-372-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET MEDICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "ONEIL",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-372-8088"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "2013",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "2013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.