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COLLABORATIVE GERIATRICS INC. NPI 1629004221


NPI Information

NPI: 1629004221
Provider Name: COLLABORATIVE GERIATRICS, INC.
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
414 MAHOGANYWOOD DR
MILTON, WV
ZIP 25541
Phone: (304) 743-8007
Get Directions

COLLABORATIVE GERIATRICS, INC. is a geriatric medicine family medicine in Milton, WV. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. COLLABORATIVE GERIATRICS, INC. NPI is 1629004221. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

414 MAHOGANYWOOD DR
MILTON, WV
ZIP 25541-181
Phone: (304) 743-8007
Fax: (304) 743-1704

The provider's authorized official is Courtney Brooke Taylor .
The authorized official title is Administrative Assistant and has the following contact phone number (304) 743-8007.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 8/22/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QG0300XFamily MedicineGeriatric Medicine21327WEST VIRGINIANo
2207QG0300XFamily MedicineGeriatric Medicine1601WEST VIRGINIANo
3207QG0300XFamily MedicineGeriatric Medicine20005WEST VIRGINIANo
4207QG0300XFamily MedicineGeriatric Medicine14713WEST 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10040807000MEDICAIDWEST 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: 5/5/2024

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