ABC PEDIATRICS, PLLC (NPI# 1154429041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154429041 |
| Entity Type | Organization |
| Organization Name | ABC PEDIATRICS, PLLC |
| Practice Address |
830 Pennsylvania Ave Suite 200 Charleston WV 25302-3302 |
| Practice Telephone | 3043431863 |
| Practice Fax Number | 3043441755 |
| Mailing Telephone | 3043431863 |
| Mailing Fax Number | 3043441755 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2011-06-23 |
| Authorized Official Name | DR. JOSEPH MATUSIC (PHYSICIAN) |
| Authorized Official Telephone | 3043431863 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 1451 | WV | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 15140 | WV | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 18217 | WV | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 16381 | WV | Allopathic & Osteopathic Physicians |
| N | 291U00000X | Clinical Medical Laboratory | 51D0910134 | WV | Laboratories |
| N | 363L00000X | Nurse Practitioner | 18804 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208000000X | Pediatrics | 731 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | SUE ANN UPTON,MD NPI # | 1922061076 | 01 |
| WV | NPI# BRENDA WALKER,CFNP | 1013971761 | 01 |
| WV | NPI # JOE MATUSIC, MD | 1912961343 | 01 |
| WV | 0167011000 | 05 | |
| WV | 1003000000 | 05 | |
| WV | 4000022000 | 05 | |
| WV | 0105170000 | 05 | |
| WV | 0107822000 | 05 | |
| WV | NPI # PENNY DIVITA,DO | 1598744757 | 01 |
| WV | 0112455000 | 05 | |
| WV | NPI # CAROL FRAIL, MD | 1295798361 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821338047 | Abc Pediatrics, Pllc | Pediatrics | 830 Pennsylvania Ave, Ste. 200, Charleston, WV 25302-3302 | 2013-02-25 |
| 1346226362 | Abc Pediatrics, Pllc | Pediatrics | 1920 Black Lake Blvd Sw, Olympia, WA 98512-5651 | 2005-12-21 |
| Street Address |
830 PENNSYLVANIA AVE SUITE 200 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25302-3302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447253497 | Scott Alan Naegele | Obstetrics & Gynecology | 830 Pennsylvania Ave, Suite 108, Charleston, WV 25302-3389 | 2005-05-23 |
| 1134678071 | Meredith Anne Chapman | Dietitian, Registered | 830 Pennsylvania Ave, Suite 103, Charleston, WV 25302-3302 | 2016-10-03 |
| 1790168409 | Muhammad Farhan Khaliq | Internal Medicine | 830 Pennsylvania Ave, Women and Children's Medical Staff Office, Suite 103, Charleston, WV 25302-3302 | 2015-06-30 |
| 1467869537 | Amarah Shakoor | Student in an Organized Health Care Education/Training Program | 830 Pennsylvania Ave, Suite 102, Charleston, WV 25302-3302 | 2014-07-21 |
| 1154734465 | Thomas Hunter & Associates, Pllc | Obstetrics & Gynecology | 830 Pennsylvania Ave, Ste 402, Charleston, WV 25302-3302 | 2014-06-04 |
| 1881031557 | Integrated Health Care Providers, Inc. | Surgery | 830 Pennsylvania Ave, Suite 305, Charleston, WV 25302-3302 | 2013-06-04 |
| 1528300829 | Brandi Elizabeth Sentz | Dietitian, Registered | 830 Pennsylvania Ave, Suite 103, Charleston, WV 25302-3302 | 2013-03-25 |
| 1821338047 | Abc Pediatrics, Pllc | Pediatrics | 830 Pennsylvania Ave, Ste. 200, Charleston, WV 25302-3302 | 2013-02-25 |
| 1174842140 | Ashley E Meyer | Pediatrics | 830 Pennsylvania Ave, Ste 103, Charleston, WV 25302-3302 | 2010-05-28 |
| 1134456171 | Marsha Harris | Registered Nurse | 830 Pennsylvania Ave, Ste 104, Charleston, WV 25302-3302 | 2009-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871963 | Sha'la Wright | Technician | 713 Orchard Street Apt. G, Charleston, WV 25302 | 2020-11-03 |
| 1154929446 | Christine Balser | Technician | 3324 Pennsylvania Avenue, Charleston, WV 25302 | 2020-10-09 |
| 1629698865 | Umer Muhammad | Student in an Organized Health Care Education/Training Program | Childrens Medicine Center, 800 Pennsylvania Ave, Charleston, WV 25302 | 2020-04-17 |
| 1689209660 | Annedie Beauty Equipment Wholesale | Prosthetic/Orthotic Supplier | 3406 Pennsylvania Avenue, Charleston, WV 25302 | 2020-03-10 |
| 1932753530 | Northwest Pharmacy, LLC | Pharmacy | 708 Bigley Ave, Ste A, Charleston, WV 25302 | 2019-07-31 |
| 1831753185 | Philip Rhoney Fending | Student in an Organized Health Care Education/Training Program | Camc Ob/gyn Center, 800 Pennsylvania Ave, Charleston, WV 25302 | 2019-04-23 |
| 1851854491 | Amee Atulkumar Amin | Student in an Organized Health Care Education/Training Program | Familycare/ Children's Medicine Center, 800 Pennsylvania Ave, Charleston, WV 25302 | 2019-04-10 |
| 1790276525 | Womencare Inc | Clinic/Center | 812 Park Ave # 35, Charleston, WV 25302 | 2018-05-29 |
| 1245729771 | Zunaira Mahmood | Student in an Organized Health Care Education/Training Program | 800 Pennsylvania Ave., Familycare/children's Medicine C, Charleston, WV 25302 | 2018-05-10 |
| 1093212383 | Rahiya Binte Rehman | Student in an Organized Health Care Education/Training Program | 800 Pennsylvania Ave Family Care / Children's Medicine, Charleston, WV 25302 | 2018-04-12 |
| Find all providers in zip 25302 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632809 | Caitlin Marie Stoll | Pediatrics | 2244 Ashley Crossing Dr Unit 536, Charleston, SC 29414-6168 | 2020-06-08 |
| 1134743420 | Elizabeth Alden Mccants | Pediatrics | 125 Doughty St Ste 520d, Charleston, SC 29403-5736 | 2020-06-02 |
| 1770127516 | Nicole Danielle Clendenin | Pediatrics | 314 Goff Mountain Rd Ste 16, Charleston, WV 25313-6600 | 2019-11-05 |
| 1871059238 | Aminah Fraser- Abdur Rahim | Pediatrics | 1373 W Lenevar Dr, Charleston, SC 29407-5148 | 2019-02-11 |
| 1720518384 | Nicholas Matthew Cundiff | Pediatrics | 135 Rutledge Ave Dept Of, Charleston, SC 29425-8903 | 2017-06-15 |
| 1649632225 | Collin Dubick | Pediatrics | 1118 Sea Eagle Watch, Charleston, SC 29412-8249 | 2016-03-23 |
| 1417338781 | Heather Michelle Greene | Pediatrics | 169 Ashlet Avenue, Room 202 Main Hospital Msc 333, Charleston, SC 29425 | 2015-06-12 |
| 1780098160 | Matthew John Saia | Pediatrics | 2124 Telfair Way, Charleston, SC 29412-2370 | 2014-06-13 |
| 1770922601 | Lauren Simpson Tipton | Pediatrics | 1243 Savannah Hwy Ste B, Charleston, SC 29407-7817 | 2013-06-25 |
| 1467747527 | Pratikkumar Patel | Pediatrics | 830 Pennsylvania Ave Ste 401, Charleston, WV 25302-3390 | 2011-06-16 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25302 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.