Individual provider Active NPI

Richard K Dattola, M.D.

  • Family Medicine Physician
  • Morgantown, WV
National Provider Identifier
1679680706
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14196 Issued in WV
Practice address
1 Medical Center Drive
Morgantown, WV 26506
Phone
(304) 598-6900
Fax
(304) 598-6914
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14196 WV Primary

Addresses

Primary practice location

1 Medical Center Drive
Morgantown, WV 26506

Mailing address

P. O. Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
0051843000MedicaidWV

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rdattola820@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address rdattola820@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address rdattola820@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000164 WV Practitioner - Family PracticePractitioner - Internal Medicine 9335111095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14196WVMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1679680706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 897",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070897",
            "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": "1 MEDICAL CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-6900",
            "fax_number": "304-598-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTOLA",
        "first_name": "RICHARD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "14196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051843000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdattola820@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdattola820@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdattola820@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6040 University Town Centre Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265012421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.