Active NPI
Dana Fawzi Ghishan, M.D
- Pediatrics Physician
- Bluefield, WV
National Provider Identifier
1619228764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 24903
- Practice address
- 500 Cherry St
Bluefield, WV 24701-3306 - Phone
- (304) 327-1100
- NPI assigned
- Sep 28, 2012
- Last updated
- Sep 28, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24903 | WV | Primary |
Addresses
Primary practice location
500 Cherry St
Bluefield, WV 24701-3306
Mailing address
611 Quail Dr
Bluefield, VA 24605-9411
Phone (520) 664-7304
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24903 | WV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Princeton Community Hospital Assn., Inc | Past | Accepting new patients | |
| Princeton Community Hospital Assn., Inc | Pediatrics | Past | Accepting new patients |
| Bluefield HBP Medical Group LLC | Past | Accepting new patients |
Interoperability endpoints
- dghishan@yourcarecommunity.org
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Bluefield, WV
- NPI 1750699260
-
- Family Medicine Physician
- Bluefield, WV
- NPI 1518273507
Pediatrics
-
dba Bluefield Internal Medicine
- Rural Health Clinic/Center
- Bluefield, VA
- NPI 1235446485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1619228764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 QUAIL DR",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246059411",
"telephone_number": "520-664-7304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CHERRY ST",
"city": "BLUEFIELD",
"state": "WV",
"postal_code": "247013306",
"telephone_number": "304-327-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHISHAN",
"first_name": "DANA",
"middle_name": "FAWZI",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-28",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "24903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluefield, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.