Active NPI
Robert L Hively, M.D.
- Family Medicine Physician
- South Charleston, WV
National Provider Identifier
1902819741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01053
- Practice address
- 707 Chestnut St
South Charleston, WV 25309-2003 - Phone
- (304) 768-8500
- Fax
- (304) 768-8530
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01053 | WV | Primary |
Addresses
Primary practice location
707 Chestnut St
South Charleston, WV 25309-2003
Mailing address
220 Ridge Dr
Dunbar, WV 25064-1310
Phone (304) 744-1949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0055497000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01053 | WV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902819741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 RIDGE DR",
"city": "DUNBAR",
"state": "WV",
"postal_code": "250641310",
"telephone_number": "304-744-1949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 CHESTNUT ST",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253092003",
"telephone_number": "304-768-8500",
"fax_number": "304-768-8530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIVELY",
"first_name": "ROBERT",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "01053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0055497000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.