Active NPI
Brendan O'Hara, MD
- Emergency Medicine Physician
- Charleston, WV
National Provider Identifier
1609852920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20588
- Practice address
- 3200 Maccorkle Ave SE
Charleston, WV 25304-1227 - Phone
- (304) 388-4170
- NPI assigned
- Dec 19, 2005
- Last updated
- Nov 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 20588 | WV | Primary |
Addresses
Primary practice location
3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Mailing address
4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001718061 | Other | WV | WV BCBS |
| 1060167 | Other | WV | WV DWC |
| 2001076000 | Medicaid | WV | |
| 1060164 | Other | WV | WV DWC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wendy L Smith M.D. PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226534400000",
"number": "1609852920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 HEMPSTEAD STATION DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454295164",
"telephone_number": "800-875-0136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 MACCORKLE AVE SE",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041227",
"telephone_number": "304-388-4170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'HARA",
"first_name": "BRENDAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2008-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WV",
"license": "20588",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WV BCBS",
"identifier": "001718061",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WV DWC",
"identifier": "1060167",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2001076000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WV DWC",
"identifier": "1060164",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}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 Nov 13, 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.