NPIMap

Organization Active NPI

Weirton Medical Center Inc

  • Pediatrics Physician
  • Weirton, WV
National Provider Identifier
1255518908
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1857 Issued in WV
Legal business name
WEIRTON MEDICAL CENTER INC
Practice address
651 Colliers Way
Suite 506
Weirton, WV 26062-5053
Phone
(304) 797-6520
NPI assigned
Jan 24, 2008
Last updated
Jan 24, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WEIRTON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Authorized official

Name
Lisa Noble, DONPI 1942263819
Title
Physician
Phone
(304) 797-6520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 1857 WV Primary

Addresses

Primary practice location

651 Colliers Way
Suite 506
Weirton, WV 26062-5053

Mailing address

PO Box 2147
Weirton, WV 26062-1347
Phone (304) 723-6040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000326 WV Part B Supplier - Clinic/Group Practice 6709771827 Receives reassigned benefits from 26 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Weirton, WV

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Stephen H Mascio DO

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1255518908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260621347",
            "telephone_number": "304-723-6040",
            "fax_number": "304-723-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 COLLIERS WAY",
            "address_2": "SUITE 506",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625053",
            "telephone_number": "304-797-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIRTON MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEIRTON MEDICAL CENTER",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "304-797-6520",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.