Active NPI
Vincent Paul Kolanko, MD
- Pediatrics Physician
- Morgantown, WV
National Provider Identifier
1225009525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 14035
- Practice address
- 1000 Mon Health Medical Park Dr Ste 1201
Morgantown, WV 26505 - Phone
- (304) 599-9400
- Fax
- (304) 599-8917
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 14035 | WV | |
| Pediatrics Physician | 208000000X | 14035 | WV | Primary |
Addresses
Primary practice location
1000 Mon Health Medical Park Dr Ste 1201
Morgantown, WV 26505
Mailing address
1428 Western Ave
Morgantown, WV 26505-2137
Other practice location 1
1300 Fort Pierpont Dr Ste 101
Morgantown, WV 26508-1314
Phone (304) 241-7150
Other practice location 2
6000 Memorial Church Drive
Morgantown, WV 26501
Phone (304) 292-7316
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110049430 | Other | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14035 | WV | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620345600000",
"number": "1225009525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1428 WESTERN AVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265052137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MON HEALTH MEDICAL PARK DR STE 1201",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26505",
"telephone_number": "304-599-9400",
"fax_number": "304-599-8917"
}
],
"practiceLocations": [
{
"address_1": "1300 Fort Pierpont Dr Ste 101",
"address_purpose": "LOCATION",
"city": "Morgantown",
"state": "WV",
"postal_code": "265081314",
"country_code": "US",
"telephone_number": "304-241-7150",
"fax_number": "304-599-8917",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6000 Memorial Church Drive",
"address_purpose": "LOCATION",
"city": "Morgantown",
"state": "WV",
"postal_code": "26501",
"country_code": "US",
"telephone_number": "304-292-7316",
"fax_number": "304-599-8917",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOLANKO",
"first_name": "VINCENT",
"middle_name": "PAUL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WV",
"license": "14035",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "14035",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "110049430",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.