NPIMap

Organization Active NPI

Wvu Sports Medicine - Uha

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Morgantown, WV
National Provider Identifier
1639308471
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
WVU SPORTS MEDICINE - UHA
Practice address
943 Maple Dr Lowr Level
Morgantown, WV 26505-2812
Phone
(304) 598-4830
NPI assigned
Jul 14, 2009
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Authorized official

Name
Robyn McDaniel
Title
Provider Relations Supervisor
Phone
(304) 293-5033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

943 Maple Dr Lowr Level
Morgantown, WV 26505-2812

Mailing address

PO Box 780
Morgantown, WV 26507-0780
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
0011526000MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Physician Office Center Dbauha Lab204 organizations share this tax ID, including this one
Part of
Physician Office Center Dbauha Lab

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

Locations

943 Maple Dr
Lowr
Morgantown, WV 26505

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1639308471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 MAPLE DR LOWR LEVEL",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052812",
            "telephone_number": "304-598-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVU SPORTS MEDICINE - UHA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "304-293-5033"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011526000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.