NPIMap

Organization Active NPI

Wvupc-Camc Medical Staff

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1851544530
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WVUPC-CAMC MEDICAL STAFF
Practice address
3100 Maccorkle Ave
Charleston, WV 25304-1223
Phone
(304) 347-1333
NPI assigned
Oct 28, 2008
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY PHYSICIANS OF CHARLESTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Robyn M McDaniel
Title
Provider Relations
Phone
(304) 293-5033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3100 Maccorkle Ave
Charleston, WV 25304-1223

Mailing address

PO Box 7000
Morgantown, WV 26507-7000
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
4002106000MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Wvu Physicians of Charl21 organizations share this tax ID, including this one
Part of
Wvu Physicians of Charl

Other organizations with this tax ID 20

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

View all 20

Locations

600 Morris St
Charleston, WV 25301
Phone (304) 347-1296

3110 Maccorkle Ave SE
Ste 504
Charleston, WV 25304

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1851544530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7000",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-347-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVUPC-CAMC MEDICAL STAFF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY PHYSICIANS OF CHARLESTON",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "304-293-5033"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4002106000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.