NPIMap

Organization Active NPI

Psimed, Inc.

  • Psychiatry Physician
  • Morgantown, WV
National Provider Identifier
1932444221
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
23697 Issued in WV
Legal business name
PSIMED, INC.
Practice address
3040 University Ave
Morgantown, WV 26505-3380
Phone
(301) 212-5526
Fax
(212) 241-5162
NPI assigned
Nov 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Mr. Terrence Eugene Rusin
Title
President/Ceo
Phone
(304) 344-8515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 23697 WV Primary

Addresses

Primary practice location

3040 University Ave
Morgantown, WV 26505-3380

Mailing address

PO Box 7310
Charleston, WV 25356-0310
Phone (304) 344-8515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050124000058 WV Part B Supplier - Clinic/Group Practice 9335199843 Receives reassigned benefits from 19 practitioners
Practice locations: Charleston, WV; Morgantown, WV

National Provider Directory

National Provider Directory

Locations

1520 Kanawha Blvd E
Charleston, WV 25311
Phone (681) 265-9047

1016 Maple Dr
Ste 104
Morgantown, WV 26505
Phone (304) 598-8764

1111 Van Voorhis Rd
Ste J
Morgantown, WV 26505
Phone (304) 212-5526

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1932444221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7310",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253560310",
            "telephone_number": "304-344-8515",
            "fax_number": "304-344-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 UNIVERSITY AVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053380",
            "telephone_number": "301-212-5526",
            "fax_number": "212-241-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSIMED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "RUSIN",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "304-344-8515",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "23697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.