NPIMap

Organization Active NPI

United Hospital Center, Inc

Doing business as UHC ENT & Audiology

  • Otolaryngology Physician
  • Bridgeport, WV
National Provider Identifier
1578733655
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
UNITED HOSPITAL CENTER, INC
Doing business as
UHC ENT & Audiology
Practice address
527 Medical Park Dr Ste 401
Bridgeport, WV 26330-9010
Phone
(681) 342-3570
Fax
(681) 342-3575
NPI assigned
Mar 5, 2008
Last updated
Nov 2, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
UNITED HOSPITAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Authorized official

Name
Michael Tillman
Title
Ceo
Phone
(681) 342-1620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

527 Medical Park Dr Ste 401
Bridgeport, WV 26330-9010

Mailing address

527 Medical Park Dr Ste 401
Bridgeport, WV 26330-9010
Phone (681) 342-3570

Other names 1

  • UHC ENT & Audiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000802 WV Part B Supplier - Clinic/Group Practice 8123936010 Receives reassigned benefits from 473 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Hall, WV; Weston, WV; Summersville, WV; Nutter Fort, WV; Grafton, WV; Glenville, WV; Fairmont, WV; Elkins, WV…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory
Part of
United Hospital Ctr

Locations

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1578733655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 401",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3570",
            "fax_number": "681-342-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 401",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3570",
            "fax_number": "681-342-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HOSPITAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITED HOSPITAL CENTER, INC",
        "enumeration_date": "2008-03-05",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "681-342-1620"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UHC ENT & Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.