Ida Z Villanueva, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12015 Issued in WV

Practice address

252 Rural Acres Dr
Beckley, WV 25801-3503

Phone

(304) 252-8551

Fax

(304) 252-1790

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1588738538
  Medicare reassignment NPD
• Community Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1194510644
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1912091133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-8551",
            "fax_number": "304-252-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-8551",
            "fax_number": "304-252-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "IDA",
        "middle_name": "Z",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "12015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "D49309",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "205832",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A12015",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048917000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "288986",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14867",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devra Venecia
• Jayne Vest
• Laura Vest
• Stephanie Dawn Via
• Vidya P Puranik
• Michele Calderon Villanueva, RN, MSN, C-FNP
• Tiffany Vines
• Voiss Therapy: Voice, Speech, & Swallowing Services, LLC
• Vishwadhipa Venkata Voore, M.D.
• W VA Orthotic & Prosthetic Center, Inc.

• Family Medicine Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.