Island Medical Bluefield LLC

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

ISLAND MEDICAL BLUEFIELD LLC

Practice address

500 Cherry St
Bluefield, WV 24701

Phone

(304) 327-1771

NPI assigned

Mar 7, 2018

Organization subpart

Yes

Parent organization

ISLAND MEDICAL BLUEFIELD LLCAs reported in NPPES

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

Authorized official

Name

Charles Wolf

Title

Cfo

Phone

(330) 656-5911

Specialties & licenses 2

Addresses

Part of

Island Medical Bluefield LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Island Medical Bluefield LLC

  • Emergency Medicine Physician
  • Bluefield, WV
  • NPI 1023561248
  NPPES parent name

Practitioners 1

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

• David W. Perdue Jr., PA-C

  • Medical Physician Assistant
  • Princeton, WV
  • NPI 1174547442
  NPD

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1871095711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74622",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940002",
            "telephone_number": "330-656-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHERRY ST",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "24701",
            "telephone_number": "304-327-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL BLUEFIELD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISLAND MEDICAL BLUEFIELD LLC",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "330-656-5911"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Icp West Virginia LLC
• Integrated WV LLC
• Internal Medicine of Bluefield, PLLC
• Mary Isabelle
• Island Medical Bluefield LLC
• Eddie Jackson
• Jain and Olmsted Partnership
• Teresa E. Jarrell, M.A.
• Domingo Gonzales Javier, MD
• Shavese Keitary Jenkins

• Hospitalist Physician in Bluefield, WV
• Providers in Bluefield, WV by specialty
• Hospitalist Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.