NPIMap

Organization Active NPI

Parkersburg Medical Associates, Inc

  • Specialist
  • Parkersburg, WV
National Provider Identifier
1528287745
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9171 Issued in WV
Legal business name
PARKERSBURG MEDICAL ASSOCIATES, INC
Practice address
1122 Market St
Parkersburg, WV 26101-4321
Phone
(304) 485-5531
Fax
(304) 485-9596
NPI assigned
Apr 25, 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. Paul Gregory Modie, M.D.
Title
President
Phone
(304) 485-5531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 9171 WV Primary

Addresses

Primary practice location

1122 Market St
Parkersburg, WV 26101-4321

Mailing address

1122 Market St
Parkersburg, WV 26101-4321
Phone (304) 485-5531

Other identifiers 2

IdentifierTypeStateIssuer
0008734000MedicaidWV
0416740MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528287745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 MARKET ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261014321",
            "telephone_number": "304-485-5531",
            "fax_number": "304-485-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 MARKET ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261014321",
            "telephone_number": "304-485-5531",
            "fax_number": "304-485-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKERSBURG MEDICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MODIE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-485-5531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "9171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008734000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0416740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.