DR. TAMEJIRO TAKUBO JR. (NPI# 1841218872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841218872 |
| Entity Type | Individual |
| Full Name | DR. TAMEJIRO TAKUBO JR. |
| Credential | D.O. |
| Practice Address |
4619 Kanawha Ave Sw South Charleston WV 25309-1319 |
| Practice Telephone | 3044004545 |
| Practice Fax Number | 3044004546 |
| Mailing Telephone | 3044004545 |
| Mailing Fax Number | 3044004546 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
1828 | WV | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
1828 | WV | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3200 Maccorkle Ave Se, Charleston, WV 253041227 | 3043885432 |
| Street Address |
4619 KANAWHA AVE SW |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962028738 | Heath Collin Barnette | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2020-06-17 |
| 1114573417 | Kelsey Strickland | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2019-08-13 |
| 1538712138 | Yezenia Soto | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2019-07-23 |
| 1477114221 | Caitlin Johnson | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2019-06-24 |
| 1568958619 | Joshua Chase Anderson | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2018-07-02 |
| 1801270749 | Jeremy Lee Smith | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2015-07-09 |
| 1083056345 | Jamie Spencer | Nurse Practitioner | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2013-07-26 |
| 1679893036 | James D. Perry | Internal Medicine | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2010-06-09 |
| 1992945745 | Frederick Paul Clayton | Internal Medicine | 4619 Kanawha Ave Sw, South Charleston, WV 25309 | 2009-03-05 |
| 1629262944 | Phillip Cox | Internal Medicine | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2007-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| 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 |
|---|---|---|---|---|
| 1174861892 | Min Jung Kim | Internal Medicine | 4619 Kanawha Avenue Sw, South Charleston, WV 25309 | 2013-01-30 |
| 1720200744 | Kevin L Eggleston | Internal Medicine | 4619 Kanawha Ave., Sw, South Charleston, WV 25309 | 2007-05-02 |
| 1497781082 | Robby L Keith | Internal Medicine | 4619 Kanawha Avenue, Se, South Charleston, WV 25309 | 2006-06-24 |
| 1679893036 | James D. Perry | Internal Medicine | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2010-06-09 |
| 1629262944 | Phillip Cox | Internal Medicine | 4619 Kanawha Ave Sw, South Charleston, WV 25309-1319 | 2007-08-29 |
| 1003029075 | William Alexander Wade | Internal Medicine | 4619 Kanawha Ave., Sw, South Charleston, WV 25309 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1467608760 | University Critical Care Associates | Internal Medicine | 185 Brockton Ln, Martinsburg, WV 25403-8372 | 2008-08-18 |
| 1710912399 | Mark Nutter Griffith | Internal Medicine | 1000 Mon Health Medical Park Dr Ste 1102, Morgantown, WV 26505 | 2006-07-11 |
| 1285607382 | Mahendrakumar M. Patel | Internal Medicine | 6 Hunters Point Rd, Charleston, WV 25314-1631 | 2006-02-09 |
| 1033189766 | Andrzej J Jaworski | Internal Medicine | 1000 Mon Health Medical Park Dr, Suite 1100, Morgantown, WV 26505-1104 | 2006-01-25 |
| 1285623108 | David A Adkins | Internal Medicine | 3100 Maccorkle Ave Se Ste 205, Charleston, WV 25304-1228 | 2005-10-14 |
| 1871095711 | Island Medical Bluefield LLC | Internal Medicine | 500 Cherry St, Bluefield, WV 24701 | 2018-03-07 |
| 1063958114 | Majdi S. Al Nabulsi | Internal Medicine | 3100 Maccorkle Ave Se Ste 205, Charleston, WV 25304-1228 | 2017-01-12 |
| 1063829349 | Vikhyath Terla | Internal Medicine | 3100 Maccorkle Ave Se Ste 205, Charleston, WV 25304-1228 | 2014-07-17 |
| 1023444783 | Monongalia County General Hospital Company | Internal Medicine | 99 J D Anderson Dr, Suite 5a, Morgantown, WV 26505-4000 | 2013-09-25 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
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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.