NPIMap

Organization Active NPI

Reynolds Memorial Hospital, Inc.

Doing business as Respiratory & Occupational Lung Disease Clinic

  • Pulmonary Disease Physician
  • Glen Dale, WV
National Provider Identifier
1265040356
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
REYNOLDS MEMORIAL HOSPITAL, INC.
Doing business as
Respiratory & Occupational Lung Disease Clinic
Practice address
800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone
(304) 843-3307
NPI assigned
Jul 15, 2020
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
David Frederick Hess
Title
Authorized Official
Phone
(304) 843-3230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

800 Wheeling Ave
Glen Dale, WV 26038-1660

Mailing address

PO Box 616
Morgantown, WV 26507-0616
Phone (304) 843-3307

Other names 1

  • Respiratory & Occupational Lung Disease Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000896 WV Part B Supplier - Clinic/Group Practice 9830184530 Receives reassigned benefits from 300 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glen Dale, WV; Moundsville, WV; New Martinsville, WV

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Francisco Lopez MD7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

407 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-3012

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1265040356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070616",
            "telephone_number": "304-843-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381660",
            "telephone_number": "304-843-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "HESS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "304-843-3230"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Respiratory & Occupational Lung Disease Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Dale, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.