Crab Orchard Medical Assoc. Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12066 Issued in WV

Legal business name

CRAB ORCHARD MEDICAL ASSOC. INC.

Practice address

1701 Robert C. Byrd Drive
Crab Orchard, WV 25827

Phone

(304) 253-8336

Fax

(304) 253-8337

NPI assigned

Oct 24, 2007

Organization subpart

No

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

Authorized official

Name

Mariza A. Lirio, M.D.NPI 1053414268

Title

Vice President

Phone

(304) 253-8336

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Mariza A Lirio, MD

  • Physical Medicine & Rehabilitation Physician
  • Crab Orchard, WV
  • NPI 1053414268
  NPD (past) Authorized official
• Apolonio E Lirio Jr., MD

  • Urology Physician
  • Crab Orchard, WV
  • NPI 1922189745
  NPD (past)

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1730378928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258271602",
            "telephone_number": "304-253-8336",
            "fax_number": "304-253-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 ROBERT C. BYRD DRIVE",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "25827",
            "telephone_number": "304-253-8336",
            "fax_number": "304-253-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAB ORCHARD MEDICAL ASSOC. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "LIRIO",
        "authorized_official_first_name": "MARIZA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-253-8336",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "12066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038505000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Brewer
• Andrew Lee Burleson, ARRT(R)(CT)
• Community Health Systems Inc
• Sarah Nicole Cooper, BSW, LSW
• Crab Orchard Medical Assoc. Inc.
• Crab Orchard Pharmacy Inc
• Kayla Deane
• Stephanie Michelle Devaney
• Patricia Dixon
• Olen Jade Dodd, CRC

• Specialist in Crab Orchard, WV
• Providers in Crab Orchard, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.