NPIMap

Organization Active NPI

United Physicians Care Inc

Doing business as Pinewood Medical Center

  • Family Medicine Physician
  • Grafton, WV
National Provider Identifier
1891863874
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNITED PHYSICIANS CARE INC
Doing business as
Pinewood Medical Center
Practice address
401 N Pike St
Grafton, WV 26354-1268
Phone
(304) 265-1350
Fax
(304) 265-0295
NPI assigned
Nov 30, 2006
Last updated
Apr 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Mr. John C Forester
Title
Chief Executive Officer
Phone
(304) 624-4655

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

401 N Pike St
Grafton, WV 26354-1268

Mailing address

686 S Pike St
Ste a
Shinnston, WV 26431-1043
Phone (304) 624-4655

Other identifiers 1

IdentifierTypeStateIssuer
3810022425MedicaidWV

Other names 1

  • Pinewood Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706001382 WV Part B Supplier - Clinic/Group Practice 6103814017 Receives reassigned benefits from 173 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clarksburg, WV; West Union, WV; Shinnston, WV; Salem, WV; Ronceverte, WV; Philippi, WV; Pennsboro, WV; Jane Lew, WV…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Accident Family Medicine24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

16 Sterling Dr
Ste 203
Bridgeport, WV 26330
Phone (304) 326-2320

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

7 Chenoweth Dr
Bridgeport, WV 26330
Phone (304) 842-3318

2307 Davisson Run Rd
Ste 300
Clarksburg, WV 26301
Phone (304) 623-1234

395 Emily Dr
Clarksburg, WV 26301
Phone (304) 662-0294

626 Elk St
Gassaway, WV 26624
Phone (304) 364-2401

426 8th St
Ste 202
Glen Dale, WV 26038
Phone (304) 843-1433

5047 Gerrardstown Rd
Ste 2
Inwood, WV 25428
Phone (304) 229-2911

2000 Foundation Way
Ste 3650
Martinsburg, WV 25401
Phone (304) 350-3274

686 S Pike St
#A
Shinnston, WV 26431
Phone (304) 624-4655

177 Middletown Rd
Ste 1
White Hall, WV 26554
Phone (304) 363-6600

Practitioners & affiliated clinicians

Practitioners 311

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.

View all 311

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1891863874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 S PIKE ST",
            "address_2": "STE A",
            "city": "SHINNSTON",
            "state": "WV",
            "postal_code": "264311043",
            "telephone_number": "304-624-4655",
            "fax_number": "304-624-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N PIKE ST",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263541268",
            "telephone_number": "304-265-1350",
            "fax_number": "304-265-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED PHYSICIANS CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "FORESTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "304-624-4655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022425",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinewood Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grafton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.