NPIMap

Organization Active NPI

WV PHS Medical Corporation

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1881907004
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WV PHS MEDICAL CORPORATION
Practice address
200 Association Dr
Suite 140
Charleston, WV 25311-1278
Phone
(901) 261-4858
Fax
(901) 261-4867
NPI assigned
Jul 16, 2010
Last updated
Jul 2, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
PROVIDER HEALTH SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Nicole Howard
Title
Cfo
Phone
(337) 991-9276

Specialties & licenses 1

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

Addresses

Primary practice location

200 Association Dr
Suite 140
Charleston, WV 25311-1278

Mailing address

1509 Dulles Drive
Lafayette, LA 70506
Phone (337) 991-9276

National Provider Directory

National Provider Directory

Locations

200 Association Dr
Ste 140
Charleston, WV 25311
Phone (337) 991-9278

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1881907004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DRIVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ASSOCIATION DR",
            "address_2": "SUITE 140",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111278",
            "telephone_number": "901-261-4858",
            "fax_number": "901-261-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV PHS MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDER HEALTH SERVICES LLC",
        "enumeration_date": "2010-07-16",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 2, 2014; 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.