NPIMap

Organization Active NPI

Stonewall Jackson Memorial Hospital

Doing business as Weston Orthopedic and Sports Medicine

  • Orthopaedic Surgery Physician
  • Weston, WV
National Provider Identifier
1841451226
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
14011 Issued in WV
Legal business name
STONEWALL JACKSON MEMORIAL HOSPITAL
Doing business as
Weston Orthopedic and Sports Medicine
Practice address
29 Hospital PLZ
Suite C
Weston, WV 26452-8470
Phone
(304) 269-4431
Fax
(304) 269-9803
NPI assigned
Jun 19, 2008
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Mr. David D Shaffer
Title
Administrator
Phone
(304) 269-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 14011 WV Primary

Addresses

Primary practice location

29 Hospital PLZ
Suite C
Weston, WV 26452-8470

Mailing address

230 Hospital PLZ
Weston, WV 26452-8558
Phone (304) 269-8000

Other identifiers 1

IdentifierTypeStateIssuer
0001417002MedicaidWV

Other names 1

  • Weston Orthopedic and Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stonewall Jackson Memorial6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1841451226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HOSPITAL PLZ",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528558",
            "telephone_number": "304-269-8000",
            "fax_number": "304-269-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL PLZ",
            "address_2": "SUITE C",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528470",
            "telephone_number": "304-269-4431",
            "fax_number": "304-269-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL JACKSON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "304-269-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "14011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001417002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weston Orthopedic and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.