Organization Active NPI

Rajendra K Jain Urology Inc

  • Urology Physician
  • Huntington, WV
National Provider Identifier
1558496489
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
WV11477 Issued in WV
Legal business name
RAJENDRA K JAIN UROLOGY INC
Practice address
2828 First Ave Suite 204
Huntington, WV 25702
Phone
(304) 525-7716
Fax
(304) 525-7717
NPI assigned
Feb 22, 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. Rajendra Kumar Jain, MD
Title
MD
Phone
(304) 525-7716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X WV11477 WV Primary

Addresses

Primary practice location

2828 First Ave Suite 204
Huntington, WV 25702

Mailing address

2828 First Ave Suite 204
Huntington, WV 25702
Phone (304) 525-7716

Other identifiers 2

IdentifierTypeStateIssuer
0380387OtherOHOH MEDICAID
0130577000MedicaidWV

National Provider Directory

National Provider Directory

Locations

2828 1st Ave
Ste 204
Huntington, WV 25702
Phone (304) 525-7111

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558496489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 FIRST AVE SUITE 204",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25702",
            "telephone_number": "304-525-7716",
            "fax_number": "304-525-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 FIRST AVE SUITE 204",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25702",
            "telephone_number": "304-525-7716",
            "fax_number": "304-525-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJENDRA K JAIN UROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "304-525-7716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "WV",
            "license": "WV11477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID",
            "identifier": "0380387",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130577000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, 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.