Tri-State Allergy, Inc

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

TRI-STATE ALLERGY, INC

Practice address

1001 20TH Street
Huntington, WV 25703

Phone

(304) 529-6100

Fax

(304) 529-0229

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Matthew C Wilson, MDNPI 1891726295

Title

President Owner

Phone

(304) 529-6100

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tri-State Allergy, Inc

  • Allergy Physician
  • Ashland, KY
  • NPI 1386786796

  1557355476

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Tri- State Allergy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Tri- State Allergy, Inc

  • Allergy Physician
  • Hurricane, WV
  • NPI 1649312083
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew C Wilson, MD

  • Allergy Physician
  • Huntington, WV
  • NPI 1891726295
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1902906019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 20TH STREET",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25703",
            "telephone_number": "304-529-6100",
            "fax_number": "304-529-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 20TH STREET",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25703",
            "telephone_number": "304-529-6100",
            "fax_number": "304-529-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE ALLERGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "304-529-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011693000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "659300083",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L0874442",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L0489556",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64694763",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L0968403",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0044083000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070510000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64698772",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie D Trent, CRNA
• Tri State Neurology PLLC
• Tri State Neuroscience Center Inc
• Tri-State Addiction Recovery Resources
• Tri-State Addiction Recovery Resources
• Tri-State Eecp
• Tri-State Eye Care Center, LTD.
• Tri-State Hearing Services LLC
• Tri-State MRI PTR
• Tri-State Occupational Medicine, Inc.

• Allergy Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Allergy Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.