MGH Surgery LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MGH SURGERY LLC

Practice address

2000 Mon Health Medical Park Drive
Suite 2200
Morgantown, WV 26505-3494

Phone

(304) 598-1200

NPI assigned

May 9, 2016

Organization subpart

No

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

Authorized official

Name

Darryl Duncan

Title

Ceo Mon Gen Hosp

Phone

(304) 598-1200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Listed as

Mon Health Center for Outpatient SurgeryCCN 51C0001016

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1831545904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MON HEALTH MEDICAL PARK DRIVE",
            "address_2": "SUITE 2200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053494",
            "telephone_number": "304-598-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MON HEALTH MEDICAL PARK DRIVE",
            "address_2": "SUITE 2200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053494",
            "telephone_number": "304-598-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGH SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "CEO MON GEN HOSP",
        "authorized_official_telephone_number": "304-598-1200"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Michael Metzner, C.R.N.A.
• Christopher John Meyer, PA-C
• Kelly M Meyers, CRNA
• Maria Bonasso Mezzanotte, D.D.S.
• Ikenna Alban Mgbehoma, MD
• Brittany Michael
• James Payden Michael
• Michelle Michael, LGSW
• Kati Michelinie, CRNA
• Jeffrey A Mick, RPH

• Ambulatory Surgical Clinic/Center in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Ambulatory Surgical Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.