NPIMap

Organization Active NPI

West Virginia University Medical Corporation Charleston Division

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1295943777
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4002106000 Issued in WV
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION CHARLESTON DIVISION
Doing business as
WVUPC Charleston Division (PAASGRP)
Practice address
3110 Maccorkle Ave SE
Charleston, WV 26507-7000
Phone
(304) 293-5033
Fax
(304) 293-6963
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Terry D Miller
Title
Provider Relations Analyst
Phone
(304) 293-5033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 4002106000 WV Primary

Addresses

Primary practice location

3110 Maccorkle Ave SE
Charleston, WV 26507-7000

Mailing address

P O Box 7000
Morgantown, WV 26507-7000
Phone (304) 293-5033

Other names 1

  • WVUPC Charleston Division (PAASGRP) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wvu Physicians of Charl21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1295943777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 7000",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-293-5033",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-293-5033",
            "fax_number": "304-293-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION CHARLESTON DIVISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PROVIDER RELATIONS ANALYST",
        "authorized_official_telephone_number": "304-293-5033"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "4002106000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WVUPC Charleston Division (PAASGRP)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.