NPIMap

Organization Active NPI

Charleston Area Medical Center, Inc.

Doing business as CAMC Cancer Center Beckley

  • Medical Oncology Physician
  • Beckley, WV
National Provider Identifier
1487439683
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
CHARLESTON AREA MEDICAL CENTER, INC.
Doing business as
CAMC Cancer Center Beckley
Practice address
275 Dry Hill Rd
Beckley, WV 25801-2605
Phone
(304) 253-6060
Fax
(304) 253-6086
NPI assigned
Aug 28, 2023
Last updated
Aug 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Bryan Luzader
Title
Provider Enrollment Manager
Phone
(304) 388-0151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RX0202X Primary

Addresses

Primary practice location

275 Dry Hill Rd
Beckley, WV 25801-2605

Mailing address

400 Association Dr Ste 102
Charleston, WV 25311-1298
Phone (304) 388-1724

Other names 1

  • CAMC Cancer Center Beckley Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000426 WV Part B Supplier - Clinic/Group Practice 3375441637 Receives reassigned benefits from 1,595 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0235350Camc Beckley Cancer Center275 Dry Hill Rd, Beckley, WV 25801AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

1836 Harper Rd
Beckley, WV 25801
Phone (304) 250-0200

3415 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-1790

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1487439683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DR STE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111298",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 DRY HILL RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012605",
            "telephone_number": "304-253-6060",
            "fax_number": "304-253-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON AREA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "LUZADER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "304-388-0151"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMC Cancer Center Beckley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.