Jefferson Memorial Hospital

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

JEFFERSON MEMORIAL HOSPITAL

Practice address

912 Somerset Blvd
Suite 100
Charles Town, WV 25401-3952

Phone

(304) 728-1601

Fax

(304) 725-3690

NPI assigned

Mar 5, 2014

Organization subpart

Yes

Parent organization

WEST VIRGINIA UNIVERSITY HOSPITALS EASTAs reported in NPPES

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

Authorized official

Name

Mr. Christopher D Knight

Title

VP Finance

Phone

(304) 264-1358

Specialties & licenses 1

Addresses

Other names 1

• Jefferson Physical Therapy Other name

Tax ID family

Jefferson Mem Hsop Eef GRP2 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.

• Jefferson Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Ranson, WV
  • NPI 1265221196
  NPD tax ID

Locations

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1477979102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FOUNDATION WAY",
            "address_2": "SUITE 2310",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019003",
            "telephone_number": "304-264-1358",
            "fax_number": "304-260-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 SOMERSET BLVD",
            "address_2": "SUITE 100",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254013952",
            "telephone_number": "304-728-1601",
            "fax_number": "304-725-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY HOSPITALS EAST",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "304-264-1358",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Interconnections Counseling and Consulting
• Ronald Jan Jackson III
• Jefferson Counseling Services, PLLC
• Jefferson County Board of Education
• Jefferson County Schools
• Jefferson Urgent Care, LLC
• Jefferson Urgent Care, LLC
• Jennifer Newman, Licsw LLC
• Lynette Yolanda Jergensen
• Joanna S. Luciano Parker, DDS, PLLC

• Physical Therapy Clinic/Center in Charles Town, WV
• Providers in Charles Town, WV by specialty
• Physical Therapy Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.