NPIMap

Organization Active NPI

Wvu Medical Corporation

Doing business as Medical Office Building-Bridgeport

  • Neurological Surgery Physician
  • Bridgeport, WV
National Provider Identifier
1245625581
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
WVU MEDICAL CORPORATION
Doing business as
Medical Office Building-Bridgeport
Practice address
227 Medical Park Drive
Bridgeport, WV 26330-9010
Phone
(681) 342-3500
Fax
(681) 342-1957
NPI assigned
Apr 3, 2015
Last updated
Apr 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Andrea M Rumble
Title
Provider Enrollment Specialist
Phone
(304) 285-7101

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

227 Medical Park Drive
Bridgeport, WV 26330-9010

Mailing address

PO Box 780
Morgantown, WV 26507-0780
Phone (304) 285-7100

Other names 1

  • MEDICAL OFFICE BUILDING-BRIDGEPORT Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000207 WV Part B Supplier - Clinic/Group Practice 1052224565 Receives reassigned benefits from 2,746 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory
Tax ID family
Wvu Medical Corp204 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

227 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-3790

Practitioners & affiliated clinicians

Practitioners 105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1245625581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7100",
            "fax_number": "304-285-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MEDICAL PARK DRIVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3500",
            "fax_number": "681-342-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVU MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "RUMBLE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "304-285-7101"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL OFFICE BUILDING-BRIDGEPORT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.