INTEGRATED HEALTH CARE PROVIDERS, INC. (NPI# 1356541114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356541114 |
| Entity Type | Organization |
| Organization Name | INTEGRATED HEALTH CARE PROVIDERS, INC. |
| Other Organization Name | RYAN WHITE PROGRAM GRANT |
| Practice Address |
3200 Maccorkle Ave Se Outpatient Care Clinic Charleston WV 25304-1227 |
| Mailing Address |
415 Morris St Suite 304 Charleston WV 25301-1842 |
| Practice Telephone | 3043888909 |
| Mailing Telephone | 3043887783 |
| Mailing Fax Number | 3043887788 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-11-15 |
| Authorized Official Name | JEFFREY H. GOODE (PRESIDENT) |
| Authorized Official Telephone | 3043887784 |
| Authorized Official Credential | PT, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810009608 | 05 |
| Other Name | Type Code |
|---|---|
| Ryan White Program Grant | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003253709 | Integrated Health Care Providers, Inc. | Psychiatry & Neurology | 1208 Hospital Drive, Hurricane, WV 25526 | 2013-06-04 |
| 1386981488 | Integrated Health Care Providers, Inc. | Urology | 707 Madison Avenue, Madison, WV 25130 | 2013-01-09 |
| 1477890630 | Integrated Health Care Providers, Inc. | Internal Medicine | 73 E 3rd Ave, Williamson, WV 25661-3530 | 2013-01-08 |
| 1154688141 | Integrated Health Care Providers, Inc. | Internal Medicine | 556 S Main St, Chapmanville, WV 25508-5001 | 2012-04-16 |
| 1730473026 | Integrated Health Care Providers, Inc. | Orthopaedic Surgery | 1399 Hospital Dr, Hurricane, WV 25526-8709 | 2011-06-03 |
| 1528390366 | Integrated Health Care Providers, Inc. | Internal Medicine | 223 Maplewood Ave, Lewisburg, WV 24901-9459 | 2010-02-04 |
| 1225243785 | Integrated Health Care Providers, Inc. | Orthopaedic Surgery | 3703 Teays Valley Road, Hurricane, WV 25526-9645 | 2007-05-10 |
| 1699873240 | Integrated Health Care Providers, Inc. | Clinical Medical Laboratory | 830 Pennsylvania Ave Ste 205, Charleston, WV 25302-3389 | 2006-09-20 |
| 1982702528 | Integrated Health Care Providers, Inc. | Internal Medicine | 3100 Maccorkle Ave Se Ste 903, Charleston, WV 25304-1276 | 2006-09-20 |
| 1659489383 | Integrated Health Care Providers, Inc. | Emergency Medicine | 130 Goff Mountain Road, Cross Lanes, WV 25313 | 2006-08-25 |
| Street Address |
3200 MACCORKLE AVE SE OUTPATIENT CARE CLINIC |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-1227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881685550 | Balakrishnan Sridharan | Internal Medicine | 3200 Maccorkle Ave Se, Hospitalists Program, Charleston, WV 25304-1227 | 2005-11-02 |
| 1982217139 | Ashley Lauren Bowles | Nurse Practitioner | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-08-27 |
| 1932717121 | Chan Myae | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-07-14 |
| 1639792971 | Victoria Morgan Bullman | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-21 |
| 1205459708 | Samantha Withrow | Nurse Practitioner | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1013530567 | Jennifer D Valdez | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1962025411 | Rhea N Lipscomb | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1780207233 | Bethany Noel Henson | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1297 | 2020-05-19 |
| 1598388043 | Travis O Ellis | Nurse Anesthetist, Certified Registered | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-05-19 |
| 1679194849 | Joshua Zegeer | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 | 2020-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669716833 | Wanetta Susie Matulis | Internal Medicine | 68 Quarry Rdg, Charleston, WV 25304-1051 | 2012-11-12 |
| 1942398235 | Fred T Kerns | Internal Medicine | 3100 Maccorkle Ave Se Ste 604, Charleston, WV 25304-1231 | 2006-10-11 |
| 1154393148 | Robert Wesley Farr | Internal Medicine | 3100 Maccorkle Ave Se Ste 902, Charleston, WV 25304-1234 | 2006-02-03 |
| 1073592937 | Infectious Diseases Consultants & Travel Medicine | Internal Medicine | 1565 Sam Rittenberg Blvd, Ste 200, Charleston, SC 29407-4138 | 2006-01-10 |
| 1780674556 | Ludwig A Lettau | Internal Medicine | 1938 Charlie Hall Blvd, Charleston, SC 29414-5837 | 2005-10-24 |
| 1831195791 | Timothy Eugene West | Internal Medicine | 1938 B Charlie Hall Blvd, Charleston, SC 29414 | 2005-06-24 |
| 1649276502 | Katherine A Minnick | Internal Medicine | 1481 Tobias Gadson Blvd Ste 1, Charleston, SC 29407-4879 | 2005-06-24 |
| 1528421658 | Henry Shiflett | Internal Medicine | 169 Ashley Avenue, Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2016-04-05 |
| 1972975241 | Ye Min Oo | Internal Medicine | 3100 Maccorkle Ave Se Ste 902, Charleston, WV 25304-1234 | 2015-10-27 |
| 1295119865 | Cameron J Selent | Internal Medicine | 1938 Charlie Hall Blvd Unit B, Charleston, SC 29414-6099 | 2015-07-14 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
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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.