Central WV Derm Assoc Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CENTRAL WV DERM ASSOC INC

Practice address

170 Thompson Dr
Suite 200
Bridgeport, WV 26330-2608

Phone

(304) 842-3494

Fax

(304) 842-2339

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Miss Georgia Dawn Daniel, CRNP

Title

Chief Operating Officer

Phone

(304) 842-3494

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 5

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

• James Blair Hill, D.O.

  • Family Medicine Physician
  • Clarksburg, WV
  • NPI 1881615375
  NPD (past)
• Karim Abdul Katrib, M.D.

  • Otolaryngology Physician
  • South Charleston, WV
  • NPI 1447242557
  NPD (past)
• Allen George Saoud, DO

  • Dermatology Physician
  • Bridgeport, WV
  • NPI 1679669345
  NPD (past)
• Fred Deshong Scott, D.O.

  • Dermatology Physician
  • Weston, WV
  • NPI 1689785677
  NPD (past)
• Frank D Swisher, DO

  • Family Medicine Physician
  • Jane Lew, WV
  • NPI 1407802218
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1669583589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4550",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304550",
            "telephone_number": "304-842-3494",
            "fax_number": "304-842-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 THOMPSON DR",
            "address_2": "SUITE 200",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263302608",
            "telephone_number": "304-842-3494",
            "fax_number": "304-842-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL WV DERM ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "304-842-3494",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003851",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2624959",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019121420001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2624968",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriella Casinelli
• Anthony Catania Jr., DPM
• Brent Jerome Cather
• Alessandra M Cava
• Mollie McCartney Cecil, M.D.
• Natalie Chambers
• Jennifer A Chaney
• Kathleen Gray Chaney, LGSW
• Francis Thomas Martinez Chavez, MD
• Gage Mackenzie Chichester

• Dermatology Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Dermatology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.