Organization Active NPI

Radiological Physician Associates Inc

  • Diagnostic Radiology Physician
  • Fairmont, WV
National Provider Identifier
1811996960
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGICAL PHYSICIAN ASSOCIATES INC
Practice address
700 Village Dr
Fairmont, WV 26554-7985
Phone
(304) 366-2600
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
John A Leon, MDNPI 1538168562
Title
President
Phone
(304) 624-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

700 Village Dr
Fairmont, WV 26554-7985

Mailing address

PO Box 890707
Charlotte, NC 28289-0707
Phone (866) 338-6463

Other identifiers 2

IdentifierTypeStateIssuer
0010747000MedicaidWV
1041208OtherWVWORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MD, SC, FL, CO, DC, OH, NJ, PA, VA, CA, HI12 enrollments

Enrollment records 12

Enrollment IDStateProvider typePAC IDDetails
O20040921000855 WV Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 29 practitioners
O20130424000153 MD Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 1 practitioner
Practice locations: Frederick, MD; Ijamsville, MD
O20130613000744 SC Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 1 practitioner
Practice locations: Johns Island, SC
O20150316001721 FL Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 2 practitioners
Practice locations: Bradenton, FL; St Petersburg, FL; Windermere, FL
O20180312000550 CO Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 1 practitioner
Practice locations: South Fork, CO
O20190806001461 DC Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 1 practitioner
Practice locations: Falls Church, VA
O20191219000284 OH Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 2 practitioners
Practice locations: Springboro, OH; Massillon, OH
O20200204002278 NJ Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 1 practitioner
Practice locations: Saddle River, NJ
O20200204002734 PA Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 2 practitioners
Practice locations: West Chester, PA
O20230214002034 VA Part B Supplier - Clinic/Group Practice 7719955368 Practice locations: Palmyra, VA
O20230301002690 CA Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Barbara, CA
O20241022004345 HI Part B Supplier - Clinic/Group Practice 7719955368 Receives reassigned benefits from 1 practitioner
Practice locations: Kailua, HI

National Provider Directory

National Provider Directory

Locations

104 Doctors Dr
Bridgeport, WV 26330
Phone (304) 842-6497

2 Hartman Plz
Buckhannon, WV 26201
Phone (304) 471-3400

700 Village Dr
Fairmont, WV 26554

1111 Van Voorhis Rd
Ste G
Morgantown, WV 26505

3 Tygart Valley Mall
White Hall, WV 26554
Phone (304) 363-6600

Practitioners & affiliated clinicians

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1811996960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890707",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890707",
            "telephone_number": "866-338-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 VILLAGE DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265547985",
            "telephone_number": "304-366-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGICAL PHYSICIAN ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-624-2121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010747000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "1041208",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.