NPIMap

Individual provider Active NPI

Aimee Renee Mae Blagovich, D.O.

  • Emergency Medicine Physician
  • Wheeling, WV
National Provider Identifier
1730486309
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2529 Issued in WV
Practice address
2000 Eoff St
Emp Office
Wheeling, WV 26003-3823
Phone
(304) 234-8111
NPI assigned
Feb 17, 2011
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2529 WV Primary
Emergency Medicine Physician 207P00000X 34-010430 OH

Addresses

Primary practice location

2000 Eoff St
Emp Office
Wheeling, WV 26003-3823

Mailing address

2000 Eoff St
Emp Office
Wheeling, WV 26003-3823
Phone (304) 234-8111

Other names 1

  • Aimee Renee Mae Washington Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120718000686 WV Practitioner - Emergency Medicine 1052576824 Reassigns benefits to 1 organization
I20160620001694 OK Practitioner - Emergency Medicine 1052576824 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-010430OHMDEmergency Medicine Physician
2529WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Jun 1, 2016 Accepting new patients
Warren Clinic Inc CurrentSince Dec 29, 2020 Accepting new patients
Ies ER Oklahoma LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince May 15, 2012 Accepting new patients
Emergency Medicine Physicians of Ohio County, PLLC Emergency Medicine Past Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Owasso Medical Facility, Inc Past Accepting new patients
St John Medical Center Inc Past Accepting new patients
Saint Francis Hospital South LLC Past Accepting new patients
Saint Francis Hospital Muskogee Inc Past Accepting new patients
St. John Broken Arrow, Inc Past Accepting new patients
Emergency Medicine Physicians of Belmont County LTD Emergency Medicine Past Accepting new patients
White Trillium Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1730486309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "address_2": "EMP OFFICE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "address_2": "EMP OFFICE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAGOVICH",
        "first_name": "AIMEE",
        "middle_name": "RENEE MAE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "2529",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34-010430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "WASHINGTON",
            "middle_name": "RENEE MAE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.