NPIMap

Organization Active NPI

Wvupc Quarry Manor

Doing business as WVU Physicians of Charleston

  • Nursing Facility/Intermediate Care Facility
  • Charleston, WV
National Provider Identifier
1942507595
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
WVUPC QUARRY MANOR
Doing business as
WVU Physicians of Charleston
Practice address
699 S Park Rd
Charleston, WV 25304-2627
Phone
(304) 347-1296
Fax
(304) 347-1394
NPI assigned
Feb 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
Terry Miller
Title
Provider Relations Analyst
Phone
(304) 293-5033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

699 S Park Rd
Charleston, WV 25304-2627

Mailing address

PO Box 7000
Morgantown, WV 26507-7000
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
4002106000MedicaidWV

Other names 1

  • WVU Physicians of Charleston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wvu Physicians of Charl21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1942507595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7000",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-293-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 S PARK RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042627",
            "telephone_number": "304-347-1296",
            "fax_number": "304-347-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WVUPC QUARRY MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PROVIDER RELATIONS ANALYST",
        "authorized_official_telephone_number": "304-293-5033"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4002106000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WVU Physicians of Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.