RETINA CONSULTANTS, PLLC (NPI# 1902800758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902800758 |
| Entity Type | Organization |
| Organization Name | RETINA CONSULTANTS, PLLC |
| Practice Address |
331 Laidley St Ste 301 Charleston WV 25301-1605 |
| Mailing Address |
Po Box 3970 Charleston WV 25339-3970 |
| Practice Telephone | 3043464400 |
| Practice Fax Number | 3043460704 |
| Mailing Telephone | 3043464400 |
| Mailing Fax Number | 3043460704 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2017-12-12 |
| Authorized Official Name | DR. ROBERT FRANK DUNDERVILL III (MANAGING PARTNER) |
| Authorized Official Telephone | 3043464400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | =========002 | WV | Allopathic & Osteopathic Physicians |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0939668 | 05 | |
| WV | 0008255000 | 05 | |
| KY | 65927964 | 05 |
| Street Address |
331 LAIDLEY ST STE 301 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25301-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861767725 | Becky Darlene Rider | Nurse Practitioner | 331 Laidley St, Charleston, WV 25301-1619 | 2012-03-12 |
| 1457620569 | Jonna Jean Wilson | Social Worker | 331 Laidley St, Suite 504, Charleston, WV 25301-1619 | 2011-12-19 |
| 1457662579 | Mountaineer Surgical Associates Pllc | Surgery | 331 Laidley St, Suite 201, Charleston, WV 25301-1619 | 2010-06-23 |
| 1972833267 | Addison Kidney Consulting Pllc | Internal Medicine | 331 Laidley St, Suite 307, Charleston, WV 25301-1619 | 2010-01-08 |
| 1982933024 | Frank J Trupo Md Pllc | Plastic Surgery | 331 Laidley St, Ste 510, Charleston, WV 25301-1619 | 2009-12-21 |
| 1538391065 | Anas Adel Alsaleh | Internal Medicine | 331 Laidley St, Suite 208, Charleston, WV 25301-1619 | 2009-08-18 |
| 1871722942 | Nariman A Halabi | Internal Medicine | 331 Laidley St, Suite208, Charleston, WV 25301-1619 | 2009-07-09 |
| 1255578076 | Anthony P. Dasaro, Md, Pllc | Internal Medicine | 331 Laidley St, Suite 307, Charleston, WV 25301-1619 | 2009-01-15 |
| 1295989119 | Kristen D Shamblin | Nurse Practitioner | 331 Laidley St, Charleston, WV 25301-1619 | 2008-11-05 |
| 1538330519 | Matthew Shaffer Md Pllc | Clinic/Center | 331 Laidley St, Suite 601, Charleston, WV 25301-1619 | 2008-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
| 1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
| 1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
| 1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
| 1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
| Find all providers in zip 25301 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| City | CHARLESTON |
| Zip Code | 25301 |
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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.