NPIMap

Organization Active NPI

Integrated Health Care Providers, Inc.

  • Clinical Medical Laboratory
  • Charleston, WV
National Provider Identifier
1891999801
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INTEGRATED HEALTH CARE PROVIDERS, INC.
Practice address
3100 Maccorkle Ave SE
Suite 101
Charleston, WV 25304-1223
Phone
(304) 388-8380
Fax
(304) 388-8388
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Authorized official

Name
Jeffrey H. Goode, PT, MBA
Title
President
Phone
(304) 388-7783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE
Suite 101
Charleston, WV 25304-1223

Mailing address

415 Morris St Ste 304
Charleston, WV 25301-1853
Phone (304) 388-7783

Other identifiers 1

IdentifierTypeStateIssuer
0014092000MedicaidWV

Other names 1

  • David Lee Cancer Center Lab Other name

National Provider Directory

National Provider Directory
Tax ID family
Integrated Health Care Providers Inc51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1891999801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-7783",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041223",
            "telephone_number": "304-388-8380",
            "fax_number": "304-388-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH CARE PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-388-7783",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014092000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David Lee Cancer Center Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 12, 2007; 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.