NPIMap

Organization Active NPI

Grant Memorial Hospital

  • Emergency Medicine Physician
  • Petersburg, WV
National Provider Identifier
1811020514
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
GRANT MEMORIAL HOSPITAL
Practice address
1 Hospital Drive
Petersburg, WV 26847
Phone
(304) 257-1026
Fax
(304) 257-1932
NPI assigned
Mar 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandy M Michaels
Title
Chief Financial Officer
Phone
(304) 257-5802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1 Hospital Drive
Petersburg, WV 26847

Mailing address

PO Box 1019
Petersburg, WV 26847-1019
Phone (304) 257-1026

Other identifiers 1

IdentifierTypeStateIssuer
0001375004MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Grant Memorial Hospial9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811020514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1019",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471019",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DRIVE",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "26847",
            "telephone_number": "304-257-1026",
            "fax_number": "304-257-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "304-257-5802"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001375004",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.