Medical Associates of Glen Daniel

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

PENDING Issued in WV

Legal business name

MEDICAL ASSOCIATES OF GLEN DANIEL

Practice address

109 Bolt Road
Glen Daniel, WV 25844

Phone

(304) 934-5125

NPI assigned

Jul 19, 2006

Last updated

Aug 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jose Jorge Gordinho, MDNPI 1124089016

Title

President

Phone

(304) 254-9022

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Medical Associates of Glen Daniel2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Medical Associates of Glen Daniel

  • Clinic/Center
  • Glen Daniel, WV
  • NPI 1548454986
  NPD tax ID

Locations

Practitioners 1

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.

• Jose Jorge Gordinho, M.D.

  • Nephrology Physician
  • Beckley, WV
  • NPI 1124089016
  NPD (past) Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1801815733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 GEORGE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012653",
            "telephone_number": "304-254-9022",
            "fax_number": "304-254-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BOLT ROAD",
            "city": "GLEN DANIEL",
            "state": "WV",
            "postal_code": "25844",
            "telephone_number": "304-934-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF GLEN DANIEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "GORDINHO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "JORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-254-9022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WV",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072202000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Gosnell
• John Christopher Higginbotham
• Cheryl Ann Len, RN
• Gunnar Martin
• Medical Associates of Glen Daniel
• Medical Associates of Glen Daniels, PLLC
• Allison Milam
• Mary Elizabeth Milam
• Joanna Carol Pettry
• Debra Gail Pope

• Rural Health Clinic/Center in Glen Daniel, WV
• Providers in Glen Daniel, WV by specialty
• Rural Health Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.