NPIMap

Organization Active NPI

Summersville Outpatient Center

  • Podiatrist
  • Summersville, WV
National Provider Identifier
1992244081
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00315 Issued in WV
Legal business name
SUMMERSVILLE OUTPATIENT CENTER
Practice address
702 Proffessional Park Dr
Summersville, WV 26651-2018
Phone
(304) 883-2381
Fax
(304) 883-2383
NPI assigned
Feb 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Deborah A Kincell
Title
Revenue Cycle Director
Phone
(304) 883-0220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 00315 WV Primary

Addresses

Primary practice location

702 Proffessional Park Dr
Summersville, WV 26651-2018

Mailing address

400 Fairview Heights Rd
Summersville, WV 26651-9308
Phone (304) 872-8402

Other names 1

  • Summersville Podiatry Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Sommerville Outpatient4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

702 Professional Park Dr
Summersville, WV 26651
Phone (304) 598-4820

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1992244081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW HEIGHTS RD",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266519308",
            "telephone_number": "304-872-8402",
            "fax_number": "304-872-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 PROFFESSIONAL PARK DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266512018",
            "telephone_number": "304-883-2381",
            "fax_number": "304-883-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERSVILLE OUTPATIENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "KINCELL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "304-883-0220"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "00315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summersville Podiatry Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.