Active NPI
Dev Raj Rellan, MD
- Nephrology Physician
- Huntington, WV
National Provider Identifier
1760421648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 09827
- Practice address
- 5170 US Route 60 E
Huntington, WV 25705-2004 - Phone
- (304) 528-4616
- Fax
- (304) 526-3228
- NPI assigned
- Jun 6, 2006
- Last updated
- Dec 9, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 09827 | WV | Primary |
Addresses
Primary practice location
5170 US Route 60 E
Huntington, WV 25705-2004
Mailing address
5170 US Route 60 E
Huntington, WV 25705-2004
Phone (304) 528-4616
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0087912000 | Medicaid | WV | |
| 111029766 | Other | MEDICARE RAILROAD | |
| 0215618 | Medicaid | OH |
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09827 | WV | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary's Himg, LLC | Nephrology | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291852800000",
"number": "1760421648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5170 US ROUTE 60 E",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257052004",
"telephone_number": "304-528-4616",
"fax_number": "304-526-3228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5170 US ROUTE 60 E",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257052004",
"telephone_number": "304-528-4616",
"fax_number": "304-526-3228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RELLAN",
"first_name": "DEV",
"middle_name": "RAJ",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2010-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "WV",
"license": "09827",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0087912000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "111029766",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0215618",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.