NPIMap

Organization Active NPI

United Hospital Center, Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Bridgeport, WV
National Provider Identifier
1376590786
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
UNITED HOSPITAL CENTER, INC.
Practice address
327 Medical Park Drive
Bridgeport, WV 26330
Phone
(681) 342-1000
NPI assigned
May 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Douglas M Coffman
Title
Cfo
Phone
(681) 342-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

327 Medical Park Drive
Bridgeport, WV 26330

Mailing address

PO Box 6209
Wheeling, WV 26003-0714
Phone (304) 233-2455

Other identifiers 4

IdentifierTypeStateIssuer
WV25724BOtherWVHEALTH PLAN
229645OtherWVCARELINK
001709474OtherWVMOUNTAIN STATE BCBS
0001276006MedicaidWV

Other names 1

  • Anesthesia Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000802 WV Part B Supplier - Clinic/Group Practice 8123936010 Receives reassigned benefits from 473 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Hall, WV; Weston, WV; Summersville, WV; Nutter Fort, WV; Grafton, WV; Glenville, WV; Fairmont, WV; Elkins, WV…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1376590786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6209",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030714",
            "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": "327 MEDICAL PARK DRIVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "681-342-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HOSPITAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "681-342-1000"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN",
            "identifier": "WV25724B",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "229645",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001709474",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001276006",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anesthesia Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.