NPIMap

Individual provider Active NPI

Samuel Gray Deem, DO

  • Urology Physician
  • Charleston, WV
National Provider Identifier
1700909702
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2176 Issued in WV
Practice address
3100 Maccorkle Ave SE
Suite 602
Charleston, WV 25304-1223
Phone
(304) 388-5120
Fax
(304) 388-5125
NPI assigned
Apr 6, 2007
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2176 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE
Suite 602
Charleston, WV 25304-1223

Mailing address

3100 Maccorkle Ave SE Ste 602
Charleston, WV 25304-1231
Phone (304) 388-5280

Other practice location 1

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

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
I20071113000323 WV Practitioner - UrologyPractitioner - Emergency MedicinePractitioner - Other (Physician) 2860580610 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
West Virginia School of Osteopathic Medicine, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1220 Lee St E
Charleston, WV 25301-1863
Phone (304) 388-7270

1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 343-4371

1521 Maplewood Ave
Ronceverte, WV 24970-8026
Phone (304) 647-5642

3100 Maccorkle Ave SE
Suite 610
Charleston, WV 25304-1231
Phone (304) 388-5280

400 Association Dr
Suite 102
Charleston, WV 25311-1298

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2176WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. Current Accepting new patients
Monongalia County General Hospital Company CurrentSince Dec 13, 2025 Accepting new patients
Camc Greenbrier Valley Medical Center Inc Urology CurrentSince Nov 1, 2024 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Nov 14, 2015 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Greenbrier VMC LLC Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Charleston Area Medical Center, Inc. Past Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 602
Charleston, WV 25304
Phone (304) 388-5120

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

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

3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

1521 Maplewood Ave
Ronceverte, WV 24970

Organizations & group practices 9

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

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1700909702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 602",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041231",
            "telephone_number": "304-388-5280",
            "fax_number": "304-388-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 602",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-388-5120",
            "fax_number": "304-388-5125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053494",
            "country_code": "US",
            "telephone_number": "304-598-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEEM",
        "first_name": "SAMUEL",
        "middle_name": "GRAY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WV",
            "license": "2176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.