Active NPI
United Physicians Care Inc
- Family Medicine Physician
- Pennsboro, WV
National Provider Identifier
1992873558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- UNITED PHYSICIANS CARE INC
- Practice address
- 21 Medical Center Dr
Pennsboro, WV 26415-1276 - Phone
- (304) 659-2986
- Fax
- (304) 659-2988
- NPI assigned
- Dec 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John C Forester
- Title
- Chief Executive Officer
- Phone
- (304) 624-4655
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
21 Medical Center Dr
Pennsboro, WV 26415-1276
Mailing address
686 S Pike St
Ste a
Shinnston, WV 26431-1043
Phone (304) 624-4655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0205557000 | Medicaid | WV |
Other names 1
- Pennsboro Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0710961 | Pennsboro Medical Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
21 Medical Center Dr
Pennsboro, WV 26415
Phone (304) 659-2986
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- West Union, WV
- NPI 1518063320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1291075200000",
"number": "1992873558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "686 S PIKE ST",
"address_2": "STE A",
"city": "SHINNSTON",
"state": "WV",
"postal_code": "264311043",
"telephone_number": "304-624-4655",
"fax_number": "304-624-3918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 MEDICAL CENTER DR",
"city": "PENNSBORO",
"state": "WV",
"postal_code": "264151276",
"telephone_number": "304-659-2986",
"fax_number": "304-659-2988"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNITED PHYSICIANS CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-01",
"last_updated": "2010-11-30",
"status": "A",
"authorized_official_last_name": "FORESTER",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "304-624-4655",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0205557000",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pennsboro Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pennsboro, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.