NPIMap

Organization Active NPI

Integrated Health Care Providers, Inc.

  • Infectious Disease Physician
  • Charleston, WV
National Provider Identifier
1356541114
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INTEGRATED HEALTH CARE PROVIDERS, INC.
Practice address
3200 Maccorkle Ave SE
Outpatient Care Clinic
Charleston, WV 25304-1227
Phone
(304) 388-8909
NPI assigned
Jul 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Jeffrey H. Goode, PT, MBA
Title
President
Phone
(304) 388-7784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Outpatient Care Clinic
Charleston, WV 25304-1227

Mailing address

415 Morris St
Suite 304
Charleston, WV 25301-1842
Phone (304) 388-7783

Other identifiers 1

IdentifierTypeStateIssuer
3810009608MedicaidWV

Other names 1

  • Ryan White Program Grant Other name

National Provider Directory

National Provider Directory
Tax ID family
Integrated Health Care Providers Inc51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1356541114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST",
            "address_2": "SUITE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011842",
            "telephone_number": "304-388-7783",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "address_2": "OUTPATIENT CARE CLINIC",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH CARE PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-388-7784",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009608",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ryan White Program Grant",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 15, 2007; 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.