Tri-State Allergy, Inc

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

TRI-STATE ALLERGY, INC

Practice address

2301 Lexington Ave Ste 105
Ashland, KY 41101-2807

Phone

(304) 529-6100

Fax

(304) 529-0229

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Matthew C Wilson, MDNPI 1891726295

Title

President

Phone

(304) 529-6100

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tri-State Allergy, Inc

  • Allergy Physician
  • Huntington, WV
  • NPI 1902906019

  1557355476

  Same PAC ID

Locations

Practitioners 2

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

• Matthew C Wilson, MD

  • Allergy Physician
  • Huntington, WV
  • NPI 1891726295

  KY

  Medicare reassignment Authorized official
• Larry Lynn Hagan, MD

  • Allergy Physician
  • Huntington, WV
  • NPI 1053350751
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1386786796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032019",
            "telephone_number": "304-529-6100",
            "fax_number": "304-529-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LEXINGTON AVE STE 105",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012807",
            "telephone_number": "304-529-6100",
            "fax_number": "304-529-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE ALLERGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-529-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64698772",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64694763",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65930083",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roderick J. Tompkins Jr., M.D.
• Tony W Dotson, DO, PLLC
• Ariel Toomey, D.O.
• Tri State Nephrology Associates PSC
• Tri State Nephrology PSC (Tri State Nephrology)
• Tri-State Ambulance Service, LLC
• Tri-State Anesthesia Group PSC
• Tri-State Anesthesiology, PSC
• Tri-State Cardiology Associates PSC
• Tri-State Diabetes and Endocrinology PLLC

• Allergy Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• Allergy Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.