NPIMap

Organization Active NPI

East River Anesthesiology Inc

  • Anesthesiology Physician
  • Princeton, WV
National Provider Identifier
1740711795
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
EAST RIVER ANESTHESIOLOGY INC
Practice address
109 Morrison Dr
Princeton, WV 24740-2322
Phone
(304) 487-3559
Fax
(304) 487-7928
NPI assigned
Mar 22, 2017
Last updated
Jun 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Authorized official

Name
Kenneth Parker, M.D.NPI 1295893360
Title
Vice President
Phone
(304) 487-3559

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
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

109 Morrison Dr
Princeton, WV 24740-2322

Mailing address

PO Box 1143
Princeton, WV 24740-1143
Phone (304) 487-3559

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170612002178 WV Part B Supplier - Clinic/Group Practice 2961770169 Receives reassigned benefits from 33 practitioners
Practice locations: Princeton, WV

National Provider Directory

National Provider Directory

Locations

109 Morrison Dr
Princeton, WV 24740
Phone (304) 487-3559

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1740711795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1143",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247401143",
            "telephone_number": "304-487-3559",
            "fax_number": "304-487-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MORRISON DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402322",
            "telephone_number": "304-487-3559",
            "fax_number": "304-487-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST RIVER ANESTHESIOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-487-3559",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.