Active NPI
Nityananda Santra, M.D.
- Surgery Physician
- Elkins, WV
National Provider Identifier
1255425278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 09853
- Practice address
- 911 Gorman Avenue
Suite 203
Elkins, WV 26241-3154 - Phone
- (304) 636-5229
- Fax
- (304) 636-1015
- NPI assigned
- Oct 3, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 09853 | WV | Primary |
Addresses
Primary practice location
911 Gorman Avenue
Suite 203
Elkins, WV 26241-3154
Mailing address
Central WV Medcorp, Inc.
P.O. Box 2630
Elkins, WV 26241-2630
Phone (304) 637-3799
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WV09853 | Other | WV | HEALTH PLAN PROVIDER # |
| 0127743000 | Medicaid | WV |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1255425278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CENTRAL WV MEDCORP, INC.",
"address_2": "P.O. BOX 2630",
"city": "ELKINS",
"state": "WV",
"postal_code": "262412630",
"telephone_number": "304-637-3799",
"fax_number": "304-637-3369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 GORMAN AVENUE",
"address_2": "SUITE 203",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413154",
"telephone_number": "304-636-5229",
"fax_number": "304-636-1015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTRA",
"first_name": "NITYANANDA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WV",
"license": "09853",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN PROVIDER #",
"identifier": "WV09853",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0127743000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.