NPIMap

Individual provider Active NPI

Kwasi Amponsah Gambrah, M.D.

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1447811872
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31544 Issued in WV
Practice address
1097 Fledderjohn Rd
Charleston, WV 25314-4208
Phone
(304) 345-3627
Fax
(304) 346-4440
NPI assigned
Jun 26, 2019
Reactivated
Mar 2, 2020
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31544 WV Primary

Addresses

Primary practice location

1097 Fledderjohn Rd
Charleston, WV 25314-4208

Mailing address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Other names 1

  • Mr. Paul Amponsah Gambrah Other name

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
I20221212002895 WV Practitioner - Family Practice 6901135110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians
Montgomery General Hospital, IncGroup PAC ID 6204735269, shared by 5 NPIs, 37 clinicians

Practice addresses (Care Compare)

1097 Fledderjohn Rd
Suite 1
Charleston, WV 25314-4208
Phone (304) 345-3627

401 6TH Ave
Montgomery, WV 25136-2116
Phone (304) 442-5151

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
372WVMDRenal Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc Family Medicine CurrentSince Nov 1, 2022 Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

1097 Fledderjohn Rd
Charleston, WV 25314
Phone (304) 345-3627

1097 Fledderjohn Rd
Ste 1
Charleston, WV 25314
Phone (304) 345-3627

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Organizations & group practices 1

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1447811872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 FLEDDERJOHN RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253144208",
            "telephone_number": "304-345-3627",
            "fax_number": "304-346-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBRAH",
        "first_name": "KWASI",
        "middle_name": "AMPONSAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "deactivation_date": "2020-02-10",
        "reactivation_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "31544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "GAMBRAH",
            "middle_name": "AMPONSAH",
            "prefix": "MR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.