NPIMap

Individual provider Active NPI

Susan Lynn Cavender, MD

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1306994710
Registry record updated Jan 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14497 Issued in WV
Practice address
1115 Lee St
Charleston, WV 25301
Phone
(304) 357-4510
Fax
(304) 357-4514
NPI assigned
Jan 8, 2007
Last updated
Jan 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14497 WV Primary

Addresses

Primary practice location

1115 Lee St
Charleston, WV 25301

Mailing address

1115 Lee St
Charleston, WV 25301
Phone (304) 357-4510

Other identifiers 1

IdentifierTypeStateIssuer
PAAS005202600MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000669 WV Practitioner - Family PracticePractitioner - Internal Medicine 1658405048 Practice locations: Charleston, WV

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Morris St
Charleston, WV 25301-1813
Phone (304) 388-5432

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14497WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susan L Cavender M.D. PLLC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262476800000",
    "number": "1306994710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 LEE ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-357-4510",
            "fax_number": "304-357-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 LEE ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-357-4510",
            "fax_number": "304-357-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVENDER",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "14497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PAAS005202600",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.