Southern West Virginia Nephrology Associates

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

22245 Issued in WV

Legal business name

SOUTHERN WEST VIRGINIA NEPHROLOGY ASSOCIATES

Practice address

300 Prosperity LN
Suite 203
Logan, WV 25601-3494

Phone

(304) 752-8800

Fax

(304) 752-9000

NPI assigned

Nov 9, 2010

Last updated

Oct 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ahmad B. Faridi, M.D.NPI 1760426068

Title

Owner

Phone

(304) 752-8800

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, KY2 enrollments

Enrollment records 2

Locations

Practitioners 4

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.

• Ahmad B Faridi, MD

  • Nephrology Physician
  • Logan, WV
  • NPI 1760426068

  KY

  Medicare reassignment Care Compare group NPD Authorized official
• Jehanzeb Bilal, M.D

  • Nephrology Physician
  • Sarasota, FL
  • NPI 1063742377

  WV

  Medicare reassignment Care Compare group
• Melissa Star Kitchen, APRN

  • Family Nurse Practitioner
  • Williamson, WV
  • NPI 1801321781

  KY, Nephrology

  Medicare reassignment NPD
• Zachary Manley, FNP-C

  • Family Nurse Practitioner
  • Logan, WV
  • NPI 1801444070
  NPD

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1346541281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PROSPERITY LN",
            "address_2": "SUITE 203",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013743",
            "telephone_number": "304-752-8800",
            "fax_number": "304-752-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PROSPERITY LN",
            "address_2": "SUITE 203",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013494",
            "telephone_number": "304-752-8800",
            "fax_number": "304-752-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN WEST VIRGINIA NEPHROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "FARIDI",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-752-8800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "42343",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WV",
            "license": "22245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Sisler
• Christina Smith
• John Walton Smith, PRSS
• Nicole Smith
• Sharla R Smith, PRSS
• Southwestern Regional Day Report Center
• Southwestern Regional Day Report Center
• Janet Sparks
• Valerie D Sparks, CRNA
• Jennifer Spaulding

• Nephrology Physician in Logan, WV
• Providers in Logan, WV by specialty
• Nephrology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.