Individual provider Active NPI

Divya Reddy Gavini, MD

  • Family Medicine Physician
  • Weirton, WV
National Provider Identifier
1487388385
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35129 Issued in WV
Practice address
651 Colliers Way Ste 413
Weirton, WV 26062-5055
Phone
(304) 797-6200
NPI assigned
Jul 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 35129 WV Primary

Addresses

Primary practice location

651 Colliers Way Ste 413
Weirton, WV 26062-5055

Mailing address

651 Colliers Way Ste 300
Weirton, WV 26062-5058

Other practice location 1

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 330-7661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250926000633 WV Practitioner - Family Practice 1456856798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WMC Physician Practices LLCGroup PAC ID 0244466753, 112 clinicians

Practice addresses (Care Compare)

651 Colliers Way
Weirton, WV 26062-5055
Phone (304) 797-6666

Hospital & facility affiliations

  • Weirton Medical Center Home Health Home health agency, Weirton, WV, CCN 517118
  • Weirton Medical Center, Inc Hospital, Weirton, WV, CCN 510023
  • Weirton Medical Center Nursing home, Weirton, WV, CCN 515077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WMC Physician Practices LLC CurrentSince Oct 1, 2025 Accepting new patients
WMC Physician Practices LLC CurrentSince Oct 1, 2025 Accepting new patients
Weirton Medical Center, Inc Past Accepting new patients

Locations

651 Colliers Way
Ste 413
Weirton, WV 26062
Phone (304) 723-7000

651 Colliers Way
Ste 300
Weirton, WV 26062
Phone (304) 797-6404

651 Colliers Way
Ste 207
Weirton, WV 26062
Phone (304) 797-6433

Organizations & group practices 3

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

Hospital & facility affiliations 3

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": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1487388385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 COLLIERS WAY STE 300",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 COLLIERS WAY STE 413",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625055",
            "telephone_number": "304-797-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-330-7661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVINI",
        "first_name": "DIVYA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "35129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

Verify at the official NPI Registry.