NPIMap

Organization Active NPI

Bassam Haffar Inc

  • Gastroenterology Physician
  • S Charleston, WV
National Provider Identifier
1649489469
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BASSAM HAFFAR INC
Practice address
117 7TH Ave
S Charleston, WV 25303-1417
Phone
(304) 395-3332
NPI assigned
May 21, 2007
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Bassam Haffar, MD
Title
Owner
Phone
(304) 395-3332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

117 7TH Ave
S Charleston, WV 25303-1417

Mailing address

6 Woodcrest LN
Charleston, WV 25314-2472
Phone (304) 395-3332

Other identifiers 8

IdentifierTypeStateIssuer
65610OtherUNICARE
41204900C2OtherOPTIMUM CHOICE
89M935491WV01OtherANTHEM BCBS
DD3845OtherRAILROAD MEDICARE
3810010229MedicaidWV
0007894724OtherAETNA
304841OtherADVANTRA FREEDOM COVERNTRY
001751446OtherMOUNTAIN STATE BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712001030 WV Part B Supplier - Clinic/Group Practice 5799711602 Receives reassigned benefits from 5 practitioners
Practice locations: S Charleston, WV

National Provider Directory

National Provider Directory

Locations

117 7th Ave
South Charleston, WV 25303
Phone (304) 345-2255

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1649489469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WOODCREST LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142472",
            "telephone_number": "304-395-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 7TH AVE",
            "city": "S CHARLESTON",
            "state": "WV",
            "postal_code": "253031417",
            "telephone_number": "304-395-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASSAM HAFFAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "HAFFAR",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-395-3332",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "65610",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "41204900C2",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "89M935491WV01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD3845",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010229",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007894724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA FREEDOM COVERNTRY",
            "identifier": "304841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001751446",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in S Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.