SOUTH CHARLESTON PEDIATRICS (NPI# 1639251036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639251036 |
| Entity Type | Organization |
| Organization Name | SOUTH CHARLESTON PEDIATRICS |
| Practice Address |
830 Pennsylvania Avenue Suite 110 Charleston WV 25302 |
| Practice Telephone | 3049827031 |
| Practice Fax Number | 3047669450 |
| Mailing Telephone | (304) 982-7031 |
| Mailing Fax Number | 3047669450 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2017-05-23 |
| Authorized Official Name | JENNIFER FISHER (OFFICE MANAGER) |
| Authorized Official Telephone | 3049827334 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 4005199000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962563593 | South Charleston Pediatrics | Clinical Medical Laboratory | 4607 Maccorkle Ave Sw, Ste 400, Charleston, WV 25309-1364 | 2006-12-13 |
| Street Address |
830 PENNSYLVANIA AVENUE SUITE 110 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902880081 | Allen Russell Chauvenet | Pediatrics | 830 Pennsylvania Avenue, West Virginia University, Charleston, WV 25302 | 2005-12-02 |
| 1720169139 | Tchuoc Poin Ly | Pediatrics | 830 Pennsylvania Avenue, Suite 400, Charleston, WV 25302-3390 | 2006-10-18 |
| 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 |
Please comment or provide details below to improve the information on SOUTH CHARLESTON PEDIATRICS.
| 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.