NPIMap

Organization Active NPI

West Virginia University Medical Corporation

  • Psychologist
  • Martinsburg, WV
National Provider Identifier
1902654288
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Practice address
61 Campus Dr Ste 200
Martinsburg, WV 25404-7542
Phone
(304) 274-6343
Fax
(304) 596-5717
NPI assigned
May 10, 2024
Last updated
May 10, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Justin Gibson
Title
VP, Finance
Phone
(304) 598-4256

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary
Clinical Psychologist 103TC0700X NU

Addresses

Primary practice location

61 Campus Dr Ste 200
Martinsburg, WV 25404-7542

Mailing address

PO Box 780
Morgantown, WV 26507-0780
Phone (304) 285-7101

National Provider Directory

National Provider Directory
Tax ID family
Uha Camc Memorial Hospi204 organizations share this tax ID, including this one
Part of
Uha Camc Memorial Hospi

Organizations with this tax ID in the same state 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1902654288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7101",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CAMPUS DR STE 200",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254047542",
            "telephone_number": "304-274-6343",
            "fax_number": "304-596-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "304-598-4256"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.