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ABC PEDIATRICS PLLC NPI 1154429041


NPI Information

NPI: 1154429041
Provider Name: ABC PEDIATRICS, PLLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 51D0910134

Address:
830 PENNSYLVANIA AVE
SUITE 200
CHARLESTON, WV
ZIP 25302
Phone: (304) 343-1863
Get Directions

ABC PEDIATRICS, PLLC is a pediatrics in Charleston, WV. The provider is 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. ABC PEDIATRICS, PLLC NPI is 1154429041. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

830 PENNSYLVANIA AVE
SUITE 200
CHARLESTON, WV
ZIP 25302-302
Phone: (304) 343-1863
Fax: (304) 344-1755

The provider's authorized official is Joseph Matusic .
The authorized official title is Physician and has the following contact phone number (304) 343-1863.

The CLIA number assigned to this NPI record is 51D0910134 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 6/23/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics1451WEST VIRGINIANo
2208000000XPediatrics15140WEST VIRGINIANo
3208000000XPediatrics18217WEST VIRGINIANo
4208000000XPediatrics16381WEST VIRGINIANo
5291U00000XClinical Medical Laboratory51D0910134WEST VIRGINIANo
6363L00000XNurse Practitioner18804WEST VIRGINIANo
7208000000XPediatrics731WEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11922061076OTHERWEST VIRGINIASUE ANN UPTON,MD NPI #
21598744757OTHERWEST VIRGINIANPI # PENNY DIVITA,DO
30107822000MEDICAIDWEST VIRGINIA
40112455000MEDICAIDWEST VIRGINIA
51013971761OTHERWEST VIRGINIANPI# BRENDA WALKER,CFNP
64000022000MEDICAIDWEST VIRGINIA
71295798361OTHERWEST VIRGINIANPI # CAROL FRAIL, MD
8F53257MEDICARE UPINWEST VIRGINIA
91003000000MEDICAIDWEST VIRGINIA
10G15685MEDICARE UPINWEST VIRGINIA
110105170000MEDICAIDWEST VIRGINIA
121912961343OTHERWEST VIRGINIANPI # JOE MATUSIC, MD
13F18699MEDICARE UPINWEST VIRGINIA
140792053MEDICARE ID-TYPE UNSPECIFIEDWEST VIRGINIAMEDICARE # PENNY DIVITA
15G42653MEDICARE UPINWEST VIRGINIA
16F53258MEDICARE UPINWEST VIRGINIA
170167011000MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.