NPIMap

Individual provider Active NPI

Alex Poulsen, DO

  • Obstetrics & Gynecology Physician
  • Charleston, WV
National Provider Identifier
1679077838
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3923 Issued in WV
Practice address
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone
(304) 388-2068
Fax
(304) 388-2437
NPI assigned
Mar 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 3923 WV Primary

Addresses

Primary practice location

800 Pennsylvania Ave
Charleston, WV 25302-3351

Mailing address

320 Karen St
South Charleston, WV 25303-1817
Phone (269) 718-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122003374 WV Practitioner - Obstetrics/Gynecology 7416206495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

830 Pennsylvania Ave
Suite 304
Charleston, WV 25302-3390
Phone (304) 388-1515

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3923WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Sep 6, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Sep 6, 2022 Accepting new patients
New River Health Association, Inc. CurrentSince Oct 30, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

830 Pennsylvania Ave
Ste 304
Charleston, WV 25302
Phone (304) 388-1515

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

497 Mall Rd
Oak Hill, WV 25901
Phone (304) 469-3261

315 Fairview Heights Rd
Summersville, WV 26651
Phone (304) 647-3500

Interoperability endpoints

  • Direct secure messaging: alex.poulsen.1@16450.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1679077838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 KAREN ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031817",
            "telephone_number": "269-718-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023351",
            "telephone_number": "304-388-2068",
            "fax_number": "304-388-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "3923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.