Ghazala Quddus Roopani, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

16972 Issued in WV

Practice address

167 Stollings Ave
Suite B
Logan, WV 25601-4010

Phone

(304) 752-8800

Fax

(304) 752-9015

NPI assigned

May 2, 2006

Last updated

Dec 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Ghazala Quddus Other name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Ghazala Quddus, M.D., Inc.

  • Nephrology Physician
  • Logan, WV
  • NPI 1184658007
  NPD (past)
• Baptist Health Deaconess Madisonville Inc

  dba Baptist Health Deaconess Madisonville Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Madisonville, KY
  • NPI 1225347719
  NPD (past)
• Pikeville Medical Center Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Whitesburg, KY
  • NPI 1871575498
  NPD (past)
• Total Renal Care Inc

  dba Kelley Corners Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lake City, SC
  • NPI 1598204802
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1528026408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 STOLLINGS AVE",
            "address_2": "SUITE B",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256014010",
            "telephone_number": "304-752-8800",
            "fax_number": "304-752-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 STOLLINGS AVE",
            "address_2": "SUITE B",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256014010",
            "telephone_number": "304-752-8800",
            "fax_number": "304-752-9015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Bypass Rd Bldg A",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "415011689",
            "country_code": "US",
            "telephone_number": "606-430-2208",
            "fax_number": "606-218-7508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17000 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708163246",
            "country_code": "US",
            "telephone_number": "225-755-4950",
            "fax_number": "225-755-4807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOPANI",
        "first_name": "GHAZALA",
        "middle_name": "QUDDUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WV",
            "license": "16972",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "29243",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "334317",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007488000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180438000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074880003",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64698947",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GHAZALA",
            "last_name": "QUDDUS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James David Roark
• Herbert Alan Roberrts III, 17500000X
• Rafael Modesto Rodighiero, PA-C
• Terri Lynn Rodighiero
• Jeremiah Sidney Romans
• Sarah Rose
• Tina Ross
• Ashlee Runyon, M.ED.
• Crystal Dawn Runyon
• Flora Runyon

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.