Active NPI
Mark C Bates, MD
- Interventional Cardiology Physician
- Charleston, WV
National Provider Identifier
1720076334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- WV15164
- Practice address
- 2345 Chesterfield Ave
Suite 302
Charleston, WV 25304-1062 - Phone
- (304) 720-2039
- Fax
- (304) 720-2041
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | WV15164 | WV | |
| Interventional Cardiology Physician | 207RI0011X | WV15164 | WV | Primary |
Addresses
Primary practice location
2345 Chesterfield Ave
Suite 302
Charleston, WV 25304-1062
Mailing address
3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 720-2039
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801626000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WV15164 | WV | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Radiologists, Inc. | Past | Accepting new patients | |
| Charleston Cardiology Group PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Charleston, WV
- NPI 1649275728
-
- Cardiovascular Disease Physician
- Charleston, WV
- NPI 1770558165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1720076334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 MACCORKLE AVE SE",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041227",
"telephone_number": "304-720-2039",
"fax_number": "304-720-2041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2345 CHESTERFIELD AVE",
"address_2": "SUITE 302",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041062",
"telephone_number": "304-720-2039",
"fax_number": "304-720-2041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "MARK",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "WV",
"license": "WV15164",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "WV",
"license": "WV15164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1801626000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.