NPIMap

Organization Active NPI

West Virginia University Medical Corporation

  • Family Medicine Physician
  • Martinsburg, WV
National Provider Identifier
1689422123
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Practice address
299 Medical CT
Martinsburg, WV 25401-2899
Phone
(304) 596-6343
Fax
(304) 263-4449
NPI assigned
May 9, 2024
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Justin Gibson
Title
VP, Finance
Phone
(304) 598-4256

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

299 Medical CT
Martinsburg, WV 25401-2899

Mailing address

PO Box 780
Morgantown, WV 26507-0780
Phone (304) 285-7101

National Provider Directory

National Provider Directory
Tax ID family
Uha Camc Memorial Hospi204 organizations share this tax ID, including this one
Part of
Uha Camc Memorial Hospi

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1689422123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7101",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 MEDICAL CT",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012899",
            "telephone_number": "304-596-6343",
            "fax_number": "304-263-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "304-598-4256"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.