NPIMap

Organization Active NPI

Occumed, LLC

  • Urgent Care Clinic/Center
  • Huntington, WV
National Provider Identifier
1639289937
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
2017-9518 Issued in WV
Legal business name
OCCUMED, LLC
Practice address
2 Stonecrest Dr
Huntington, WV 25701-9391
Phone
(304) 525-2273
Fax
(304) 525-2165
NPI assigned
Aug 30, 2006
Last updated
May 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Mr. Timothy Martin
Title
VP & Coo
Phone
(304) 526-2052

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Urgent Care Clinic/Center 261QU0200X 005812 WV
Urgent Care Clinic/Center 261QU0200X 2017-9518 WV Primary
Occupational Medicine Clinic/Center 261QX0100X 2017-9518 WV
Occupational Medicine Clinic/Center 261QX0100X 005812 WV
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

2 Stonecrest Dr
Huntington, WV 25701-9391

Mailing address

2 Stonecrest Dr
Huntington, WV 25701-9391
Phone (304) 525-2273

Other identifiers 6

IdentifierTypeStateIssuer
7100387040OtherKYKY MEDICAID PA
1639289937MedicaidWV
7100350570OtherKYKY MEDICAID NP
7100053990OtherKYKY MEDICAID DO/MD
2643689MedicaidOH
3810006253MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061121000309 WV Part B Supplier - Clinic/Group Practice 6507864899 Receives reassigned benefits from 25 practitioners
Practice locations: Huntington, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0688260Occumed LLC2 Stonecrest Drive, Huntington, WV 25701Certificate of waiverDec 14, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2 Stonecrest Dr
Huntington, WV 25701
Phone (304) 525-2273

750 Oak St
Kenova, WV 25530
Phone (304) 453-6136

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1639289937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 STONECREST DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257019391",
            "telephone_number": "304-525-2273",
            "fax_number": "304-525-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STONECREST DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257019391",
            "telephone_number": "304-525-2273",
            "fax_number": "304-525-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUMED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "VP & COO",
        "authorized_official_telephone_number": "304-526-2052",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "WV",
            "license": "005812",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "WV",
            "license": "2017-9518",
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "WV",
            "license": "2017-9518",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "WV",
            "license": "005812",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID PA",
            "identifier": "7100387040",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639289937",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID NP",
            "identifier": "7100350570",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID DO/MD",
            "identifier": "7100053990",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2643689",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006253",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD EMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.