Individual provider Active NPI

Gudjon Karlsson, MD

  • Interventional Cardiology Physician
  • Huntington, WV
National Provider Identifier
1235558339
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
25239 Issued in WV
Practice address
5170 US Route 60
Huntington, WV 25705-2004
Phone
(304) 528-4600
NPI assigned
Apr 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 25239 WV Primary

Addresses

Primary practice location

5170 US Route 60
Huntington, WV 25705-2004

Mailing address

5170 US Route 60
Huntington, WV 25705-2004
Phone (304) 528-4600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GudjonKarlsson@himg.directbygreenway.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140617000304 WV Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0547484461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Medical Center, Inc. Interventional Cardiology CurrentSince Aug 1, 2017 Accepting new patients
St. Mary'S Medical Center Inc CurrentSince Aug 1, 2017 Accepting new patients

Locations

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

147 Willow Tree Way
Hurricane, WV 25526
Phone (304) 397-3002

Interoperability endpoints

  • Direct secure messaging: gudjonkarlsson@himg.directbygreenway.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/704af85e-ff7f-4141-a47d-5f79ab640202/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1235558339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052004",
            "telephone_number": "304-528-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052004",
            "telephone_number": "304-528-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARLSSON",
        "first_name": "GUDJON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WV",
            "license": "25239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GudjonKarlsson@himg.directbygreenway.com",
            "affiliation": "N",
            "address_1": "5170 US Route 60",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257052004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.