Organization Active NPI

Mountain State Medicine and Rheumatology PLLC

Doing business as MSMR Specialty

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1982720801
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MOUNTAIN STATE MEDICINE AND RHEUMATOLOGY PLLC
Doing business as
MSMR Specialty
Practice address
1120 Kanawha Blvd E Ste 200
Charleston, WV 25301-2400
Phone
(304) 400-4900
Fax
(304) 400-4907
NPI assigned
Mar 22, 2007
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Doshia K Petry Ward, CMOM, CMC,CMPM, CMA
Title
Practice Manager
Phone
(304) 400-4900

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Specialist 174400000X 1818 WV
Specialist 174400000X 1767 WV
Internal Medicine Physician 207R00000X NU Primary
Rheumatology Physician 207RR0500X NU
Non-Pharmacy Dispensing Site 332900000X NU

Addresses

Primary practice location

1120 Kanawha Blvd E Ste 200
Charleston, WV 25301-2400

Mailing address

1120 Kanawha Blvd E Ste 200
Charleston, WV 25301-2400
Phone (304) 400-4900

Other names 2

  • MSMR Specialty Doing business as
  • MSMR Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050819000426 WV Part B Supplier - Clinic/Group Practice 0446280382 Receives reassigned benefits from 3 practitioners
Practice locations: Charleston, WV

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1044564Mountain State Medicine & Rheumatology PLLC1120 Kanawha Boulevard East, Suite 200, Charleston, WV 25301Certificate of waiverAug 22, 2027

National Provider Directory

National Provider Directory

Locations

1120 Kanawha Blvd E
Ste 200
Charleston, WV 25301
Phone (304) 400-4900

400 Division St
Ste 10
South Charleston, WV 25309
Phone (304) 767-7890

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1982720801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 KANAWHA BLVD E STE 200",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012400",
            "telephone_number": "304-400-4900",
            "fax_number": "304-400-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 KANAWHA BLVD E STE 200",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012400",
            "telephone_number": "304-400-4900",
            "fax_number": "304-400-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATE MEDICINE AND RHEUMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "DOSHIA K",
        "authorized_official_middle_name": "PETRY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "304-400-4900",
        "authorized_official_credential": "CMOM, CMC,CMPM, CMA"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "1818",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "1767",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSMR Specialty",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MSMR",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MSMR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 12, 2026; 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.