Individual provider Active NPI

Ananthan Krishnathas, MD

  • Internal Medicine Physician
  • South Charleston, WV
National Provider Identifier
1891786554
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21702 Issued in WV
Practice address
4605 Maccorkle Ave. SW
South Charleston, WV 25309
Phone
(304) 766-3526
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21702 WV Primary

Addresses

Primary practice location

4605 Maccorkle Ave. SW
South Charleston, WV 25309

Mailing address

4605 Maccorkle Ave. SW
South Charleston, WV 25309
Phone (304) 766-3526

Other identifiers 1

IdentifierTypeStateIssuer
3810000987MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000770 WV Practitioner - HospitalistPractitioner - Internal Medicine 6709849086 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners Inc 366 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Hospital & facility affiliations

  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21702WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of West Virginia-Wheeling, PLLC Internal Medicine CurrentSince Dec 14, 2019 Accepting new patients
THS Physician Partners Inc Internal Medicine CurrentSince Apr 17, 2024 Accepting new patients
Hospitalist Medicine Physicians of West Virginia- TCG PLLC Internal Medicine CurrentSince Feb 12, 2022 Accepting new patients
Herbert J. Thomas Memorial Hospital Association Past Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

333 Laidley St
Charleston, WV 25301
Phone (304) 347-6116

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

Organizations & group practices 5

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 1

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1891786554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE. SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-766-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE. SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-766-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNATHAS",
        "first_name": "ANANTHAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "21702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000987",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.