NPIMap

Individual provider Active NPI

Antoine Katiny, MD

  • Internal Medicine Physician
  • Burnsville, WV
National Provider Identifier
1407816416
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17332 Issued in WV
Practice address
110 Municipal Street
Burnsville, WV 26335-0424
Phone
(304) 853-2278
Fax
(304) 853-2520
NPI assigned
Mar 24, 2006
Last updated
Apr 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17332 WV Primary

Addresses

Primary practice location

110 Municipal Street
Burnsville, WV 26335-0424

Mailing address

110 Municipal Street
Burnsville, WV 26335-0424
Phone (304) 853-2278

Other identifiers 2

IdentifierTypeStateIssuer
0075944000MedicaidWV
0034771000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071024000057 WV Practitioner - Internal MedicinePractitioner - Family Practice 2062508948 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 Municipal St
Burnsville, WV 26335-0424

PO Box
Suite 424
Burnsville, WV 26335-0424

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17332WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beckley Emergency Physicians LLC CurrentSince Sep 6, 2021 Accepting new patients
Appalachian Regional Healthcare, Inc. Internal Medicine Current Accepting new patients
Appalachian Regional Healthcare, Inc CurrentSince Jan 29, 2018 Accepting new patients
Appalachian Regional Healthcare, Inc CurrentSince Jan 29, 2018 Accepting new patients
Oak Hill Emergency Physicians, LLC CurrentSince Oct 12, 2015 Accepting new patients
Burnsville Drug Store Past Accepting new patients
Antoine Katiny MD Past Accepting new patients

Locations

1828 Harper Rd
Beckley, WV 25801
Phone (304) 253-4004

250 Stanaford Rd
Beckley, WV 25801
Phone (304) 252-7331

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

430 Main St W
Oak Hill, WV 25901
Phone (276) 325-0678

Interoperability endpoints

  • Direct secure messaging: antoinekatiny@arh.medalliesdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Burnsville Medical Center PLLCBurnsville, WV, CCN 513884 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 4, 1994

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1407816416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MUNICIPAL STREET",
            "city": "BURNSVILLE",
            "state": "WV",
            "postal_code": "263350424",
            "telephone_number": "304-853-2278",
            "fax_number": "304-853-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MUNICIPAL STREET",
            "city": "BURNSVILLE",
            "state": "WV",
            "postal_code": "263350424",
            "telephone_number": "304-853-2278",
            "fax_number": "304-853-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATINY",
        "first_name": "ANTOINE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "17332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075944000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0034771000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, WV

Sources for this page

Verify at the official NPI Registry.