Wvdhhr John Manchin Sr Health Care Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WVDHHR JOHN MANCHIN SR HEALTH CARE CENTER

Practice address

401 Guffey Street
Fairmont, WV 26554

Phone

(304) 363-2500

Fax

(304) 363-0263

NPI assigned

Aug 1, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Carol D Merrill, NHA

Title

Ceo Administrator

Phone

(304) 363-2500

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Tax ID family

Wvdhhr John Manchin Sr Health Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wvdhhr John Manchin Sr. Health Care Center

  • Nursing Facility/Intermediate Care Facility
  • Fairmont, WV
  • NPI 1922404649
  NPD tax ID

Practitioners 1

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

• James Namsupak, M.D.

  • General Practice Physician
  • Fairmont, WV
  • NPI 1043486145

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1417963000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 GUFFEY STREET",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-363-2500",
            "fax_number": "304-363-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GUFFEY STREET",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "26554",
            "telephone_number": "304-363-2500",
            "fax_number": "304-363-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVDHHR JOHN MANCHIN SR HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO ADMINISTRATOR",
        "authorized_official_telephone_number": "304-363-2500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "C13880",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delilah Ray Wright
• Kimberly R Wright, MS, PT
• Greg Joseph Wrobleski, DDS
• Alexis Nicole Wunderlich, OTR/L
• WV Durable Medical Equipment Co, LLC
• Wvdhhr John Manchin Sr. Health Care Center
• Tenille Wyer
• Jennifer Wyne
• Yale Academy LLC
• April Yanero

• Family Medicine Physician in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.