NPIMap

Organization Active NPI

United Hospital Center Inc

  • Orthopaedic Surgery Physician
  • Bridgeport, WV
National Provider Identifier
1720133473
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
107 Issued in WV
Legal business name
UNITED HOSPITAL CENTER INC
Practice address
227 Medical Park Dr Ste 101
Bridgeport, WV 26330-9038
Phone
(681) 342-3500
Fax
(681) 342-3507
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Michael Tillman
Title
Ceo
Phone
(681) 342-1620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 107 WV Primary

Addresses

Primary practice location

227 Medical Park Dr Ste 101
Bridgeport, WV 26330-9038

Mailing address

527 Medical Park Dr Ste 400
Bridgeport, WV 26330-9010
Phone (681) 342-3500

Other identifiers 1

IdentifierTypeStateIssuer
3810008621MedicaidWV

Other names 1

  • UHC Orthopedics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000802 WV Part B Supplier - Clinic/Group Practice 8123936010 Receives reassigned benefits from 473 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Hall, WV; Weston, WV; Summersville, WV; Nutter Fort, WV; Grafton, WV; Glenville, WV; Fairmont, WV; Elkins, WV…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1720133473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 400",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3500",
            "fax_number": "681-342-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MEDICAL PARK DR STE 101",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309038",
            "telephone_number": "681-342-3500",
            "fax_number": "681-342-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HOSPITAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "681-342-1620"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008621",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UHC Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.