Organization Active NPI

Dean Kyer MD, PLLC

  • Specialist
  • Charleston, WV
National Provider Identifier
1508069352
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
19792 Issued in WV
Legal business name
DEAN KYER MD, PLLC
Practice address
414 Greenway Ave
Suite 100
Charleston, WV 25309-1426
Phone
(304) 766-4444
Fax
(304) 766-4447
NPI assigned
Jun 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dean Kyer, MD
Title
Owner
Phone
(304) 766-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 19792 WV Primary

Addresses

Primary practice location

414 Greenway Ave
Suite 100
Charleston, WV 25309-1426

Mailing address

414 Greenway Ave
Suite 100
Charleston, WV 25309-1426
Phone (304) 766-4444

Other identifiers 1

IdentifierTypeStateIssuer
5600067000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000246 WV Part B Supplier - Clinic/Group Practice 5092950964 Receives reassigned benefits from 1 practitioner
Practice locations: South Charleston, WV

National Provider Directory

National Provider Directory

Locations

414 Greenway Ave
Ste 100
South Charleston, WV 25309
Phone (304) 766-4444

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508069352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 GREENWAY AVE",
            "address_2": "SUITE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253091426",
            "telephone_number": "304-766-4444",
            "fax_number": "304-766-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 GREENWAY AVE",
            "address_2": "SUITE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253091426",
            "telephone_number": "304-766-4444",
            "fax_number": "304-766-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN KYER MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KYER",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-766-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "19792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5600067000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.