Organization Active NPI

Healogics Specialty Physicians of West Virginia, PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Logan, WV
National Provider Identifier
1992220321
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
HEALOGICS SPECIALTY PHYSICIANS OF WEST VIRGINIA, PLLC
Practice address
20 Hospital Dr
Logan, WV 25601-3452
Phone
(855) 689-5105
Fax
(888) 507-9833
NPI assigned
Aug 7, 2017
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Frank Williams
Title
Ceo
Phone
(904) 446-3519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X Primary

Addresses

Primary practice location

20 Hospital Dr
Logan, WV 25601-3452

Mailing address

5220 Belfort Rd Ste 130
Jacksonville, FL 32256-6018
Phone (855) 689-5105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171120000220 WV Part B Supplier - Clinic/Group Practice 8820354210 Receives reassigned benefits from 5 practitioners
Practice locations: Logan, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1502064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1992220321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566018",
            "telephone_number": "855-689-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "855-689-5105",
            "fax_number": "888-507-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALOGICS SPECIALTY PHYSICIANS OF WEST VIRGINIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-07",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-446-3519"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.