Active NPI
Kenneth Edward Damato, D.O.
- Orthopaedic Surgery Physician
- Elkins, WV
National Provider Identifier
1346274925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 1153
- Practice address
- 100 Seneca Road
Elkins, WV 26241-1457 - Phone
- (304) 636-8080
- Fax
- (304) 636-8849
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 1153 | WV | Primary |
Addresses
Primary practice location
100 Seneca Road
Elkins, WV 26241-1457
Mailing address
Central WV Medcorp, Inc.
PO Box 2630
Elkins, WV 26241-2630
Phone (304) 637-3799
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WV01153 | Other | WV | HEALTH PLAN |
| P00247557 | Other | RAILROAD MEDICARE | |
| 0097229000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1153 | WV | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain State Medical Specialties, PLLC | Past | 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 and National Provider Directory roles.
-
- Dermatology Physician
- Bridgeport, WV
- NPI 1891892097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1346274925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CENTRAL WV MEDCORP, INC.",
"address_2": "PO BOX 2630",
"city": "ELKINS",
"state": "WV",
"postal_code": "262412630",
"telephone_number": "304-637-3799",
"fax_number": "304-637-3369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SENECA ROAD",
"city": "ELKINS",
"state": "WV",
"postal_code": "262411457",
"telephone_number": "304-636-8080",
"fax_number": "304-636-8849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMATO",
"first_name": "KENNETH",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WV",
"license": "1153",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN",
"identifier": "WV01153",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00247557",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0097229000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.