NPIMap

Organization Active NPI

West Virginia University Medical Corporation Charleston Division

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1568671980
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6705038001 Issued in WV
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION CHARLESTON DIVISION
Doing business as
WVUPC Family Med Ctr Chas (PAASGRP)
Practice address
1201 Washington St E
Suite 108
Charleston, WV 25301-1834
Phone
(304) 293-5033
Fax
(304) 293-6963
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Terry Miller
Title
Provider Relations Analyst
Phone
(304) 293-5033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 6705038001 WV Primary

Addresses

Primary practice location

1201 Washington St E
Suite 108
Charleston, WV 25301-1834

Mailing address

PO Box 7000
Morgantown, WV 26507-7000
Phone (304) 293-5033

Other names 1

  • WVUPC Family Med Ctr Chas (PAASGRP) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wvu Physicians of Charl21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1568671980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7000",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-293-5033",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 WASHINGTON ST E",
            "address_2": "SUITE 108",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011834",
            "telephone_number": "304-293-5033",
            "fax_number": "304-293-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION CHARLESTON DIVISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PROVIDER RELATIONS ANALYST",
        "authorized_official_telephone_number": "304-293-5033"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "6705038001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WVUPC Family Med Ctr Chas (PAASGRP)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.