Individual provider Active NPI

David Leon Soulsby, M.D.

  • Orthopaedic Surgery Physician
  • South Charleston, WV
National Provider Identifier
1508868043
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
13599 Issued in WV
Practice address
610 Chestnut St
South Charleston, WV 25309-1251
Phone
(304) 766-7515
Fax
(304) 766-7566
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 13599 WV Primary

Addresses

Primary practice location

610 Chestnut St
South Charleston, WV 25309-1251

Mailing address

138 Leslie PL
Scott Depot, WV 25560-8902
Phone (304) 757-2476

Other identifiers 2

IdentifierTypeStateIssuer
000503590OtherWVBCBS WEST VIRGINIA
0097603000MedicaidWV

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
I20100707000174 WV Practitioner - Orthopedic Surgery 1456329671

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: dsoulsby317421@direct.wvuhsdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1508868043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LESLIE PL",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255608902",
            "telephone_number": "304-757-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 CHESTNUT ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091251",
            "telephone_number": "304-766-7515",
            "fax_number": "304-766-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULSBY",
        "first_name": "DAVID",
        "middle_name": "LEON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "13599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WEST VIRGINIA",
            "identifier": "000503590",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097603000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.