NPIMap

Organization Active NPI

Eastern Panhandle Anesthesia Associates

  • Pain Medicine (Anesthesiology) Physician
  • Martinsburg, WV
National Provider Identifier
1902866882
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
EASTERN PANHANDLE ANESTHESIA ASSOCIATES
Practice address
2500 Hospital Road
Martinsburg, WV 25401
Phone
(304) 264-8933
Fax
(304) 264-8846
NPI assigned
Mar 24, 2006
Last updated
Jan 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Authorized official

Name
Jack F. Shamblin III, MDNPI 1831159615
Title
President
Phone
(304) 264-8933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary

Addresses

Primary practice location

2500 Hospital Road
Martinsburg, WV 25401

Mailing address

109 Mount Wood Rd
Wheeling, WV 26003
Phone (304) 233-2455

Other identifiers 2

IdentifierTypeStateIssuer
0203593000MedicaidWV
CI6384OtherWVRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1902866882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MOUNT WOOD RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-233-2455",
            "fax_number": "304-233-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL ROAD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-264-8933",
            "fax_number": "304-264-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PANHANDLE ANESTHESIA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "SHAMBLIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-264-8933",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203593000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI6384",
            "state": "WV"
        }
    ],
    "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 Jan 14, 2010; 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.