NPIMap

Organization Active NPI

Medexpress Urgent Care, PLLC - Charleston

  • Urgent Care Clinic/Center
  • Charleston, WV
National Provider Identifier
1740448430
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
01026 Issued in WV
Legal business name
MEDEXPRESS URGENT CARE, PLLC - CHARLESTON
Practice address
5430 Maccorkle Ave SE
Charleston, WV 25304-2224
Phone
(304) 925-3627
Fax
(304) 925-1163
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Timothy Bugin
Title
VP of Payor Contracting
Phone
(304) 225-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X
Urgent Care Clinic/Center 261QU0200X 01026 WV Primary

Addresses

Primary practice location

5430 Maccorkle Ave SE
Charleston, WV 25304-2224

Mailing address

PO Box 719
Dellslow, WV 26531-0719
Phone (304) 985-3627

Other identifiers 2

IdentifierTypeStateIssuer
51D1089045OtherWVCLIA
3810012430MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1740448430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "DELLSLOW",
            "state": "WV",
            "postal_code": "265310719",
            "telephone_number": "304-985-3627",
            "fax_number": "304-985-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042224",
            "telephone_number": "304-925-3627",
            "fax_number": "304-925-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE, PLLC - CHARLESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "BUGIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "VP OF PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "WV",
            "license": "01026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "51D1089045",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012430",
            "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 Feb 13, 2012; 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.