WVUPC HEARTLAND OF CHARLESTON (NPI# 1588961130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588961130 |
| Entity Type | Organization |
| Organization Name | WVUPC HEARTLAND OF CHARLESTON |
| Other Organization Name | WVU PHYSICIANS OF CHARLESTON |
| Practice Address |
3819 Chesterfield Ave Charleston WV 25304-2647 |
| Mailing Address |
Po Box 7000 Morgantown WV 26507-7000 |
| Practice Telephone | 3043471296 |
| Practice Fax Number | 3043471394 |
| Mailing Telephone | 3042937401 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-02-17 |
| Authorized Official Name | TERRY MILLER (PROVIDER RELATIONS ANALYST) |
| Authorized Official Telephone | 3042935033 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 4002106000 | 05 |
| Other Name | Type Code |
|---|---|
| WVU Physicians of Charleston | Doing Business As Name - Organization |
| Street Address |
3819 CHESTERFIELD AVE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-2647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962447037 | Health Care and Retirement Corporation of America LLC | Skilled Nursing Facility | 3819 Chesterfield Ave, Charleston, WV 25304-2647 | 2006-06-20 |
| 1649899261 | Taylor Hartleben | Nurse Practitioner | 3819 Chesterfield Ave, Charleston, WV 25304-2647 | 2020-04-14 |
| 1427464148 | Heather Dawn Petry | Nurse Practitioner | 3819 Chesterfield Ave, Charleston, WV 25304-2647 | 2014-07-02 |
| 1972936482 | Eastbrook Center LLC | Nursing Facility/Intermediate Care Facility | 3819 Chesterfield Ave, Charleston, WV 25304-2647 | 2013-08-20 |
| 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 | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659555761 | Tallahatchie General Hospital and Extended Care Facility | Nursing Facility/Intermediate Care Facility | 201 South Market Street, Charleston, MS 38921 | 2007-12-26 |
| 1760520936 | Greenhurst, Inc. | Nursing Facility/Intermediate Care Facility | 226 Skyler Dr, Pob 458, Charleston, AR 72933-9337 | 2007-02-01 |
| 1972936482 | Eastbrook Center LLC | Nursing Facility/Intermediate Care Facility | 3819 Chesterfield Ave, Charleston, WV 25304-2647 | 2013-08-20 |
| 1942507595 | Wvupc Quarry Manor | Nursing Facility/Intermediate Care Facility | 699 S Park Rd, Charleston, WV 25304-2627 | 2011-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336524586 | Bridgeport Health Care Center, LLC | Nursing Facility/Intermediate Care Facility | Rt 4 Box 17, Bridgeport, WV 26330-9509 | 2015-07-29 |
| 1629453766 | Rainelle Center LLC | Nursing Facility/Intermediate Care Facility | 276 Pennsylvania Ave, Rainelle, WV 25962-1177 | 2015-07-29 |
| 1558754507 | Lewisburg Center LLC | Nursing Facility/Intermediate Care Facility | 979 Rocky Hill Rd, Ronceverte, WV 24970-8028 | 2015-03-16 |
| 1467845412 | Wellsburg Center LLC | Nursing Facility/Intermediate Care Facility | 70 Valley Haven Dr, Wellsburg, WV 26070-2625 | 2015-03-16 |
| 1508254319 | Mary Bird | Nursing Facility/Intermediate Care Facility | 590 North Poplar Fork Rd, Hurricane, WV 25526-9434 | 2014-12-31 |
| 1952536377 | Springfield Center LLC | Nursing Facility/Intermediate Care Facility | 10797 Seneca Trl S, Lindside, WV 24951-7345 | 2009-05-29 |
| 1720281975 | Pleasant Valley Nursing and Rehabilitation Center, Inc. | Nursing Facility/Intermediate Care Facility | 640 Sandhill Rd, Pt Pleasant, WV 25550-2163 | 2007-06-06 |
| 1255427415 | Bridgeport Senior Living, LLC | Nursing Facility/Intermediate Care Facility | Rr 4 Box 17, Bridgeport, WV 26330-9509 | 2006-10-05 |
| 1194816025 | Lakin Hospital | Nursing Facility/Intermediate Care Facility | 1 Bateman Cir, Lakin, WV 25287-9784 | 2006-09-27 |
| 1922100031 | Morgantown Healthcare Corp | Nursing Facility/Intermediate Care Facility | 30 Vandervort Dr, Morgantown, WV 26505 | 2006-09-01 |
| Find all providers with the same taxonomy | ||||
| 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.