NPIMap

Organization Active NPI

Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
National Provider Identifier
1568401461
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
GREENBRIER EMERGENCY SERVICES, INC.
Practice address
100 Hoylman Dr
Gassaway, WV 26624-9320
Phone
(304) 364-5156
NPI assigned
Jun 6, 2006
Last updated
Jan 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
Dr. Randal L. Dabbs, M.D.NPI 1326095035
Title
President
Phone
(865) 693-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

100 Hoylman Dr
Gassaway, WV 26624-9320

Mailing address

PO Box 634715
Cincinnati, OH 45263-4715
Phone (888) 203-1274

Other identifiers 2

IdentifierTypeStateIssuer
0207350-000MedicaidWV
001712003OtherWVWEST VIRGINIA BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000043 WV Part B Supplier - Clinic/Group Practice 2668377359 Receives reassigned benefits from 264 practitioners
Practice locations: Beckley, WV; Weirton, WV
O20191011002500 AR Part B Supplier - Clinic/Group Practice 2668377359 Receives reassigned benefits from 70 practitioners
Practice locations: Conway, AR; North Little Rock, AR

National Provider Directory

National Provider Directory

Locations

20 Hospital Dr
#1453
Logan, WV 25601
Phone (304) 792-1101

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Practitioners & affiliated clinicians

Practitioners 447

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 447

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1568401461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634715",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452634715",
            "telephone_number": "888-203-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOYLMAN DR",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266249320",
            "telephone_number": "304-364-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIER EMERGENCY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "DABBS",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-693-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207350-000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA BLUE SHIELD",
            "identifier": "001712003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gassaway, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.