Organization Active NPI

Mid-Ohio Valley Medical Group Inc.

  • Family Medicine Physician
  • Belpre, OH
National Provider Identifier
1235353103
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1514286 Issued in OH
Legal business name
MID-OHIO VALLEY MEDICAL GROUP INC.
Practice address
610 Washington Blvd
Suite 1
Belpre, OH 45714-2465
Phone
(740) 423-5055
Fax
(740) 423-5058
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Mrs. Lisa G Hays
Title
Office Coordinator
Phone
(304) 485-4439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1514286 OH Primary

Addresses

Primary practice location

610 Washington Blvd
Suite 1
Belpre, OH 45714-2465

Mailing address

800 Grand Central Mall
Suite 4
Vienna, WV 26105-4100
Phone (304) 485-4439

Other identifiers 3

IdentifierTypeStateIssuer
2751991MedicaidOH
3810008457MedicaidWV
DF3852OtherOHRAILROAD MEDICARE PIN

National Provider Directory

National Provider Directory

Locations

610 Washington Blvd
#1
Belpre, OH 45714
Phone (740) 423-5055

610 Washington Blvd
Ste 1
Belpre, OH 45714
Phone (740) 423-5055

604 Ann St
Parkersburg, WV 26101
Phone (304) 422-0405

418 Grand Park Dr
Ste 311
Parkersburg, WV 26105
Phone (304) 485-7700

Practitioners & affiliated clinicians

Practitioners 1

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1235353103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 4",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-485-4439",
            "fax_number": "304-485-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WASHINGTON BLVD",
            "address_2": "SUITE 1",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457142465",
            "telephone_number": "740-423-5055",
            "fax_number": "740-423-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-OHIO VALLEY MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "HAYS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "304-485-4439",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "1514286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2751991",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008457",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "DF3852",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belpre, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.