Whitehall Medical PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1552 Issued in WV

Legal business name

WHITEHALL MEDICAL PLLC

Practice address

177 Middletown Rd
Suite 1
Fairmont, WV 26554-8216

Phone

(304) 363-6600

Fax

(304) 363-7700

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard E. Vasicek, DONPI 1316037146

Title

Member Owner

Phone

(304) 363-6600

Specialties & licenses 1

Addresses

Other identifiers 3

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Richard E Vasicek, DO

  • Family Medicine Physician
  • Fairmont, WV
  • NPI 1316037146
  Authorized official Same address or phone
• Michael T Montgomery, D.O.

  • Family Medicine Physician
  • Hinton, WV
  • NPI 1366553166
  NPD (past)
• Thomas Bucinski, MD

  • Emergency Medicine Physician
  • Harrisburg, IL
  • NPI 1073541355
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1659432631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 MIDDLETOWN RD",
            "address_2": "SUITE 1",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548216",
            "telephone_number": "304-363-6600",
            "fax_number": "304-363-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 MIDDLETOWN RD",
            "address_2": "SUITE 1",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548216",
            "telephone_number": "304-363-6600",
            "fax_number": "304-363-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEHALL MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "VASICEK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEMBER OWNER",
        "authorized_official_telephone_number": "304-363-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "WV",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "2411485",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006289",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS",
            "identifier": "001711083",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Lynn White
• Patricia Ann White
• Tina Elisa White
• Sherie Yvonne Whitecotton
• Anita Whitehair
• Whitehall Pharmacy LLC
• Elizabeth Jane Whitelock
• Katherine Anne Wickerd
• Trisha Nicole Wickline
• Frank Wiechers, FNP-BC

• General Practice Physician in Fairmont, WV
• Providers in Fairmont, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.