NPIMap

Organization Active NPI

Integrated Health Care Providers, Inc.

  • Clinical Medical Laboratory
  • Charleston, WV
National Provider Identifier
1700080710
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INTEGRATED HEALTH CARE PROVIDERS, INC.
Practice address
415 Morris St Ste 309
Charleston, WV 25301-1853
Phone
(304) 388-3290
Fax
(304) 388-3186
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Jeffery H. Goode, PT, MBA
Title
President
Phone
(304) 388-7783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

415 Morris St Ste 309
Charleston, WV 25301-1853

Mailing address

415 Morris St Ste 304
Charleston, WV 25301-1853
Phone (304) 388-7783

Other identifiers 1

IdentifierTypeStateIssuer
6702025-003MedicaidWV

Other names 1

  • Facial Surgery Center I Lab Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0922316Camc Facial Surgery General415 Morris Street Suite 309, Charleston, WV 25301Certificate of waiverNov 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Integrated Health Care Providers Inc51 organizations share this tax ID, including this one

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

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1700080710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-7783",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 309",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-3290",
            "fax_number": "304-388-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH CARE PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-388-7783",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6702025-003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Facial Surgery Center I Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.