NPIMap

Organization Active NPI

Lungcenter, Inc.

  • Pulmonary Disease Physician
  • Glen Dale, WV
National Provider Identifier
1740491315
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
18009 Issued in WV
Legal business name
LUNGCENTER, INC.
Practice address
426 8TH St
Room 305
Glen Dale, WV 26038-1451
Phone
(304) 843-5041
Fax
(304) 845-4586
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Melvin Theodore Saludes, MDNPI 1275643314
Title
Owner
Phone
(304) 843-5041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 18009 WV Primary

Addresses

Primary practice location

426 8TH St
Room 305
Glen Dale, WV 26038-1451

Mailing address

PO Box 6244
Wheeling, WV 26003-0722
Phone (304) 843-5041

Other identifiers 4

IdentifierTypeStateIssuer
0076373000MedicaidWV
0941020MedicaidOH
9345582OtherWVMEDICARE ID
9345581OtherOHMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040728001328 OH Part B Supplier - Clinic/Group Practice 1254301195 Receives reassigned benefits from 3 practitioners
Practice locations: Martins Ferry, OH; Saint Clairsville, OH
O20040728001426 WV Part B Supplier - Clinic/Group Practice 1254301195 Receives reassigned benefits from 4 practitioners
Practice locations: Glen Dale, WV; Wheeling, WV

National Provider Directory

National Provider Directory

Locations

4697 Harrison St
Fl 2
Bellaire, OH 43906
Phone (304) 843-5041

90 N 4th St
#28
Martins Ferry, OH 43935

90 N 4th St
Ste 28
Martins Ferry, OH 43935

51520 National Rd
Ste 7
Saint Clairsville, OH 43950

500 Medical Park
#2
Wheeling, WV 26003

Practitioners & affiliated clinicians

Practitioners 9

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": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1740491315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6244",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030722",
            "telephone_number": "304-843-5041",
            "fax_number": "304-845-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 8TH ST",
            "address_2": "ROOM 305",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381451",
            "telephone_number": "304-843-5041",
            "fax_number": "304-845-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNGCENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "SALUDES",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-843-5041",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WV",
            "license": "18009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076373000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0941020",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "9345582",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "9345581",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Dale, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.