WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION


Address: 527 Medical Park Dr, Suite 108, Bridgeport, WV 26330-9008
Phone: 3048482152

WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION (NPI# 1457605404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457605404
Entity Type Organization
Organization Name WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Other Organization Name WVU OBSTETRICS & GYNECOLOGY-BRIDGEPORT
Practice Address 527 Medical Park Dr
Suite 108
Bridgeport
WV 26330-9008
Mailing Address P O Box 780
Morgantown
WV 26507-0780
Practice Telephone 3048482152
Mailing Telephone 3042857101
Enumeration Date 2012-10-30
Last Update Date 2012-10-30
Authorized Official Name TERRY D MILLER (PROVIDER ENROLLMENT SPECIALIST)
Authorized Official Telephone 3042857101
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory 51D2012387 WV Laboratories

Other Provider Identifier

State Issuer Identifier Type Code
WV 0011526000 05

Other Provider/Organization Names

Other Name Type Code
WVU Obstetrics & Gynecology-Bridgeport Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1962655613 West Virginia University Medical Corporation Emergency Medicine 301 Suncrest Towne Centre Drive, Morgantown, WV 26505-1874 2008-10-28
1932301934 West Virginia University Medical Corporation Family Medicine 117 Taylor Street, Harpers Ferry, WV 25424 2007-06-01
1518480847 West Virginia University Medical Corporation Clinic/Center 100 Stoney Hill Rd, Fairmont, WV 26554-1589 2017-07-19
1548457740 West Virginia University Medical Corporation Durable Medical Equipment & Medical Supplies 1 Medical Center Drive, Morgantown, WV 26506 2007-10-02
1952503971 West Virginia University Medical Corporation Family Medicine 117 Taylor Street, Harpers Ferry, WV 25425 2007-06-01
1255540530 West Virginia University Medical Corporation Clinical Medical Laboratory 171 Taylor Street, Harpers Ferry, WV 25425 2007-05-22
1275504508 West Virginia University Medical Corporation Orthopaedic Surgery 1 Medical Center Drive, Morgantown, WV 26506 2006-01-26

Office Location

Street Address 527 MEDICAL PARK DR
SUITE 108
City BRIDGEPORT
State WV
Zip Code 26330-9008

Providers in the same location

NPI Name Taxonomy Address Enumeration
1134101660 United Hospital Center Inc Family Medicine 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9010 2005-11-18
1760967400 Susan Rennae Kirkendall Counselor 527 Medical Park Dr, Bridgeport, WV 26330-9008 2018-09-28
1457886988 Rachel S Holeman Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-21
1205360237 Nathan E Russell Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-17
1255865275 Brandon M Lewko Emergency Medicine 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-17
1144754177 Premkumar Chandrakantbhai Patel General Practice 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-17
1922546175 Leslie D. Mavromatis Counselor 527 Medical Park Dr, Bridgeport, WV 26330-9008 2017-02-08
1316491996 Ellen Palmer Hoban Nurse Practitioner 527 Medical Park Dr, Suite 105, Bridgeport, WV 26330-9008 2016-08-11
1194170571 Matthan Jackson Family Medicine 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 2016-05-04
1447605837 Arsalan Khawaja Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 2016-05-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992303036 Gage Mackenzie Chichester Nurse Anesthetist, Certified Registered 2673 Medical Park Drive, Bridgeport, WV 26330 2020-10-12
1851914105 Melany Langhurst Social Worker 64 Professional Place, Suite 102, Bridgeport, WV 26330 2020-05-21
1245704980 Adam Christopher Stonestreet Social Worker Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 2019-01-16
1588146658 Bridgeport Physical Therapy Services, Inc. Occupational Therapist 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 2018-09-05
1275040685 White Oaks Assisted Living Assisted Living Facility 140 Professional Place White Oaks, Bridgeport, WV 26330 2018-01-08
1275049371 Regional Eye Associates, Inc Ophthalmology 220 Southview Drive, Bridgeport, WV 26330 2017-12-27
1528586187 Savanna Tamia Brown Social Worker 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 2017-09-05
1184079642 Karla Kay Rinehart Social Worker 27 Trovato St., Suite 103, Bridgeport, WV 26330 2016-05-03
1396176756 Willo Group LLC Pharmacy 460 E. Main Street, Bridgeport, WV 26330 2013-12-10
1891031878 Sherri Michelle Dobson Occupational Therapy Assistant 1000 Maplewood Dr, Bridgeport, WV 26330 2012-12-20
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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154747442 Mountain State Medical Specialties,inc. Clinical Medical Laboratory 120 Medical Park Dr Ste 101, Bridgeport, WV 26330-9013 2014-03-11
1457610180 Apsp-bridgeport, LLC Clinical Medical Laboratory 1905 Doctor's Hospital Drive, Doctor's Hospital, Bridgeport, TX 76246 2012-05-15
1154549095 Laboratory Corporation of America Holdings Clinical Medical Laboratory 4750 Main St, Bridgeport, CT 06606-1823 2007-04-24
1760968598 Monitor My Health, Inc. Clinical Medical Laboratory 1000 Lafayette Blvd Ste 1100, Bridgeport, CT 06604-4710 2018-07-15
1366836066 Fst Lab, LLC Clinical Medical Laboratory 48 Alpine St, Bridgeport, CT 06610-1727 2015-03-20
1851650832 Oncology Hematology Associates Pllc Clinical Medical Laboratory 327 Medical Park Dr, Bridgeport, WV 26330-9006 2012-05-10
1619152436 United Physicians Care Inc Clinical Medical Laboratory 1511 Johnson Ave, Ste 104, Bridgeport, WV 26330-1016 2007-12-31
1649395021 Oncology Hematology Associates Lab Clinical Medical Laboratory 327 Medical Park Drive, Bridgeport, WV 26330-9006 2007-03-21
1578692679 Medbrook Medical Assoc. Inc. Clinical Medical Laboratory 1370 Johnson Ave, Bridgeport, WV 26330-1382 2007-03-05
1538256805 Pediatric Associate Clinical Medical Laboratory 11 Chenoweth Dr, Suite A, Bridgeport, WV 26330-1675 2006-10-06
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City BRIDGEPORT
Zip Code 26330

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Dataset Information

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.

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