NPIMap

Organization Active NPI

Charleston Area Medical Center

  • Specialist
  • Charleston, WV
National Provider Identifier
1396964185
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
41107 Issued in WV
Legal business name
CHARLESTON AREA MEDICAL CENTER
Practice address
3100 Maccorkle Ave SE
Suite 202
Charleston, WV 25304-1223
Phone
(304) 388-4973
Fax
(304) 388-4968
NPI assigned
Apr 24, 2007
Last updated
Sep 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Ms. Dawn Lynn Bacchus, C-FNP (APRN-BC)
Title
Nurse Practitioner
Phone
(304) 388-4973

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 41107 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE
Suite 202
Charleston, WV 25304-1223

Mailing address

132 Riverview Dr
Tornado, WV 25202-9716
Phone (304) 388-4973

National Provider Directory

National Provider Directory
Tax ID family
Dane E Beavers MD68 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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1396964185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 RIVERVIEW DR",
            "city": "TORNADO",
            "state": "WV",
            "postal_code": "252029716",
            "telephone_number": "304-388-4973",
            "fax_number": "304-388-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 202",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-388-4973",
            "fax_number": "304-388-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON AREA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "304-388-4973",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C-FNP (APRN-BC)"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "41107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 10, 2009; 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.