NPIMap

Individual provider Active NPI

Walter P Thrush, MD

  • Diagnostic Radiology Physician
  • Fairmont, WV
National Provider Identifier
1871592832
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
15110 Issued in WV
Practice address
700 Village Dr
Fairmont, WV 26554-7985
Phone
(304) 366-2600
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 15110 WV 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 1

IdentifierTypeStateIssuer
0118651000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080304000011 WV Practitioner - Diagnostic Radiology 6709854383 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
West Virginia University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiological Physician Associates IncGroup PAC ID 7719955368, 31 clinicians

Practice addresses (Care Compare)

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1000

RT 250 S Route 4 Box 315
Barbour County Family Medicine
Philippi, WV 26416
Phone (304) 457-5744

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Imaging and Intervention, PLLC Diagnostic Radiology CurrentSince Apr 28, 2020 Accepting new patients
Pendleton Community Care Inc CurrentSince Apr 19, 2011 Accepting new patients
Pendleton Community Care Inc CurrentSince Apr 19, 2011 Accepting new patients
Radiological Physician Associates Inc Diagnostic Radiology CurrentSince Oct 21, 1997 Accepting new patients
Pendleton Community Care, Inc. Current Accepting new patients
Pendleton Community Care Inc Past Accepting new patients
Minnie Hamilton Health Care Center, Inc. Past Accepting new patients

Locations

400 Court St
#303
Charleston, WV 25301
Phone (304) 345-1503

700 Village Dr
Fairmont, WV 26554

186 Hospital Dr
Grantsville, WV 26147
Phone (304) 354-9244

1111 Van Voorhis Rd
Ste G
Morgantown, WV 26505

122 Pinnell St
#720
Ripley, WV 25271
Phone (866) 871-7843

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1871592832",
    "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": {
        "last_name": "THRUSH",
        "first_name": "WALTER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WV",
            "license": "15110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118651000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.