Organization Active NPI

Larry a Dodd MD PLLC

  • Otolaryngology Physician
  • Wheeling, WV
National Provider Identifier
1356548580
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
LARRY A DODD MD PLLC
Practice address
30 Medical Park
Suite 223
Wheeling, WV 26003-6391
Phone
(304) 234-2060
Fax
(304) 234-2070
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Larry A Dodd, MD
Title
President
Phone
(304) 233-2455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

30 Medical Park
Suite 223
Wheeling, WV 26003-6391

Mailing address

PO Box 6847
Wheeling, WV 26003-0666
Phone (304) 233-2455

Other identifiers 2

IdentifierTypeStateIssuer
0419738MedicaidOH
1802957000MedicaidWV

National Provider Directory

National Provider Directory

Locations

20 Medical Park
Ste 223
Wheeling, WV 26003
Phone (304) 234-2061

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1356548580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6847",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030666",
            "telephone_number": "304-233-2455",
            "fax_number": "304-233-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL PARK",
            "address_2": "SUITE 223",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036391",
            "telephone_number": "304-234-2060",
            "fax_number": "304-234-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY A DODD MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "DODD",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-233-2455",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0419738",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802957000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.