NPIMap

Organization Active NPI

West Virginia University Physician of Charleston-Valley Center

  • Skilled Nursing Facility
  • South Charleston, WV
National Provider Identifier
1790924454
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WEST VIRGINIA UNIVERSITY PHYSICIAN OF CHARLESTON-VALLEY CENTER
Practice address
1000 Lincoln Dr
South Charleston, WV 25309-2304
Phone
(304) 768-4410
Fax
(304) 768-4416
NPI assigned
Feb 19, 2009
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY PHYSICIANS OF CHARLESTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Authorized official

Name
Robyn M McDaniel
Title
Provider Relations Supervisor
Phone
(304) 293-5033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1000 Lincoln Dr
South Charleston, WV 25309-2304

Mailing address

PO Box 7000
Morgantown, WV 26507-7000
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
4002106000MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Wvu Physicians of Charl21 organizations share this tax ID, including this one
Part of
Wvu Physicians of Charl

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

1000 Lincoln Dr
South Charleston, WV 25309
Phone (304) 766-1722

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235001600000",
    "number": "1790924454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7000",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN DR",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253092304",
            "telephone_number": "304-768-4410",
            "fax_number": "304-768-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY PHYSICIAN OF CHARLESTON-VALLEY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY PHYSICIANS OF CHARLESTON",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "304-293-5033"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4002106000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.