NPIMap

Organization Active NPI

Cabell Huntington Hospital Inc

  • Family Medicine Physician
  • Kenova, WV
National Provider Identifier
1205044898
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CABELL HUNTINGTON HOSPITAL INC
Practice address
750 Oak St
Kenova, WV 25530-1517
Phone
(304) 526-2000
NPI assigned
May 18, 2007
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Kevin Fowler, CEO
Title
Chief Executive Officer
Phone
(304) 526-2000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 48 WV
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

750 Oak St
Kenova, WV 25530-1517

Mailing address

1340 Hal Greer Blvd
Huntington, WV 25701-3800
Phone (304) 526-2000

Other identifiers 7

IdentifierTypeStateIssuer
001821272OtherWV BC BS
001988269OtherWV BC BS
3810005796MedicaidWV
001783596OtherWV BC BS
65942039MedicaidKY
001710105OtherWV BC BS CLINIC PROV
2460519MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000461 WV Part B Supplier - Clinic/Group Practice 3274436340 Receives reassigned benefits from 185 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hurricane, WV; South Charleston, WV; Scott Depot, WV; Huntington, WV; Barboursville, WV

Other NPIs on the same Medicare enrollment 17

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

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1015221Cabell Huntington Hospital Family Medical Center750 Oak Street, Kenova, WV 25530Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory

Locations

750 Oak St
Kenova, WV 25530
Phone (304) 453-6136

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1205044898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013800",
            "telephone_number": "304-526-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 OAK ST",
            "city": "KENOVA",
            "state": "WV",
            "postal_code": "255301517",
            "telephone_number": "304-526-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABELL HUNTINGTON HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "304-526-2000",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WV",
            "license": "48",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BC BS",
            "identifier": "001821272",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BC BS",
            "identifier": "001988269",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005796",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BC BS",
            "identifier": "001783596",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65942039",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BC BS CLINIC PROV",
            "identifier": "001710105",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2460519",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenova, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.