NPIMap

Organization Active NPI

Raleigh Lung Clinic Incorporated PC

  • Pulmonary Disease Physician
  • Beckley, WV
National Provider Identifier
1689808925
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
20964 Issued in WV
Legal business name
RALEIGH LUNG CLINIC INCORPORATED PC
Practice address
2401 S Kanawha St
Suite 100
Beckley, WV 25801-6967
Phone
(304) 255-6300
Fax
(304) 255-6301
NPI assigned
May 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Ramzi N. Haddadin, MD
Title
Owner
Phone
(304) 255-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 20964 WV Primary

Addresses

Primary practice location

2401 S Kanawha St
Suite 100
Beckley, WV 25801-6967

Mailing address

43 Fox Sparrow Rd
Beckley, WV 25801-3687
Phone (304) 255-6300

Other identifiers 5

IdentifierTypeStateIssuer
3810014810MedicaidWV
002103799OtherWVBCBS
1059099OtherWVADVANTRA
B614349000OtherWVFECA/ENERGY
7530440OtherWVAETNA PIN

National Provider Directory

National Provider Directory

Locations

2401 S Kanawha St
Beckley, WV 25801
Phone (304) 255-1080

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1689808925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 FOX SPARROW RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013687",
            "telephone_number": "304-255-6300",
            "fax_number": "304-255-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S KANAWHA ST",
            "address_2": "SUITE 100",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016967",
            "telephone_number": "304-255-6300",
            "fax_number": "304-255-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH LUNG CLINIC INCORPORATED PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "HADDADIN",
        "authorized_official_first_name": "RAMZI",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-255-6300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WV",
            "license": "20964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810014810",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "002103799",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA",
            "identifier": "1059099",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FECA/ENERGY",
            "identifier": "B614349000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7530440",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.