NPIMap

Organization Active NPI

Grant Memorial Hospital

  • Internal Medicine Physician
  • Petersburg, WV
National Provider Identifier
1316329121
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GRANT MEMORIAL HOSPITAL
Practice address
117 Hospital Dr
Petersburg, WV 26847-9566
Phone
(304) 257-4331
Fax
(304) 257-2891
NPI assigned
Jun 29, 2015
Last updated
Jan 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Nicholas Mezza
Title
Cfo
Phone
(304) 257-5802

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

117 Hospital Dr
Petersburg, WV 26847-9566

Mailing address

PO Box 1019
Petersburg, WV 26847-1019
Phone (304) 257-4331

Other names 1

  • GRANT MEMORIAL HOSPITALISTS Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1316329121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1019",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471019",
            "telephone_number": "304-257-4331",
            "fax_number": "304-257-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 HOSPITAL DR",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268479566",
            "telephone_number": "304-257-4331",
            "fax_number": "304-257-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "MEZZA",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-257-5802"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANT MEMORIAL HOSPITALISTS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GRANT MEMORIAL HOSPITALISTS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.