Island Medical Service Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8646 Issued in WV

Legal business name

ISLAND MEDICAL SERVICE INC

Practice address

103 S Penn St
Wheeling, WV 26003-2075

Phone

(304) 232-2100

Fax

(304) 232-8272

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Basil P Papadimitriou, MD

Title

President

Phone

(304) 232-2100

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932230703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PENN ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032075",
            "telephone_number": "304-232-2100",
            "fax_number": "304-232-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S PENN ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032075",
            "telephone_number": "304-232-2100",
            "fax_number": "304-232-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAPADIMITRIOU",
        "authorized_official_first_name": "BASIL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-232-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "8646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6693636",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055704000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Wheeling, WV
• Providers in Wheeling, 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 Aug 22, 2020; 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.