Individual provider Active NPI

Reena Ghodasara, MD

  • Student in an Organized Health Care Education/Training Program
  • Charleston, WV
National Provider Identifier
1457703167
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3200 Maccorkle Ave SE
Camc Family Medicine Center, 5TH Floor
Charleston, WV 25304-1227
Phone
(304) 388-4600
Fax
(304) 388-4603
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Camc Family Medicine Center, 5TH Floor
Charleston, WV 25304-1227

Mailing address

3200 Maccorkle Ave SE
Camc Family Medicine Center, 5TH Floor
Charleston, WV 25304-1227
Phone (304) 388-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1457703167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "address_2": "CAMC FAMILY MEDICINE CENTER, 5TH FLOOR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4600",
            "fax_number": "304-388-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "address_2": "CAMC FAMILY MEDICINE CENTER, 5TH FLOOR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4600",
            "fax_number": "304-388-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHODASARA",
        "first_name": "REENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.