Alpha Omega Medical PLLC

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

Legal business name

ALPHA OMEGA MEDICAL PLLC

Doing business as

Advanded OBGYN Womens Center

Practice address

77 Hospital Dr
Logan, WV 25601-3451

Phone

(304) 400-6262

NPI assigned

May 23, 2017

Last updated

Dec 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Emad Mousa, MDNPI 1003070194

Title

Doctor

Phone

(304) 896-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanded OBGYN Womens Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 1

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.

• Emad Y Mousa, MD

  • Obstetrics Physician
  • Logan, WV
  • NPI 1003070194

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1497283352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256010119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013451",
            "telephone_number": "304-400-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA OMEGA MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-23",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "MOUSA",
        "authorized_official_first_name": "EMAD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "304-896-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "24508",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanded OBGYN Womens Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obstetrics Physician in Logan, WV
• Providers in Logan, WV by specialty
• Obstetrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.