Active NPI
Alexander Sample
- Family Medicine Physician
- Wheeling, WV
National Provider Identifier
1740803501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4164
- Practice address
- 32 20TH St Ste 430
Wheeling, WV 26003-3746 - Phone
- (304) 902-6720
- NPI assigned
- May 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4164 | WV | Primary |
Addresses
Primary practice location
32 20TH St Ste 430
Wheeling, WV 26003-3746
Mailing address
32 20TH St Ste 430
Wheeling, WV 26003-3746
Phone (304) 902-6720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4164 | WV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1740803501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 20TH ST STE 430",
"city": "WHEELING",
"state": "WV",
"postal_code": "260033746",
"telephone_number": "304-902-6720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 20TH ST STE 430",
"city": "WHEELING",
"state": "WV",
"postal_code": "260033746",
"telephone_number": "304-902-6720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE",
"first_name": "ALEXANDER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-27",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "4164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheeling, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.