NPIMap

Organization Active NPI

Charleston Area Medical Center, Inc.

Doing business as CAMC Pediatric & Adult ENT

  • Otolaryngology Physician
  • Charleston, WV
National Provider Identifier
1598544975
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CHARLESTON AREA MEDICAL CENTER, INC.
Doing business as
CAMC Pediatric & Adult ENT
Practice address
1311 Virginia St E Ste 100
Charleston, WV 25301-3011
Phone
(304) 353-0210
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Bryan Luzader
Title
Provider Enrollment Manager
Phone
(304) 388-0151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1311 Virginia St E Ste 100
Charleston, WV 25301-3011

Mailing address

400 Association Dr Ste 102
Charleston, WV 25311-1298
Phone (304) 388-1724

Other names 1

  • CAMC Pediatric & Adult ENT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dane E Beavers MD72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1598544975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASSOCIATION DR STE 102",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111298",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 VIRGINIA ST E STE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013011",
            "telephone_number": "304-353-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON AREA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "LUZADER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "304-388-0151"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMC Pediatric & Adult ENT",
            "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 Sep 26, 2023; 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.