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MOUNTAIN STATE MEDICAL ASSOCIATES PLLC NPI 1447349238


NPI Information

NPI: 1447349238
Provider Name: MOUNTAIN STATE MEDICAL ASSOCIATES PLLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 51D0961757

Address:
300 KENTON DR
SUITE 100
CHARLESTON, WV
ZIP 25311
Phone: (304) 346-5533
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MOUNTAIN STATE MEDICAL ASSOCIATES PLLC is an internal medicine in Charleston, WV. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MOUNTAIN STATE MEDICAL ASSOCIATES PLLC NPI is 1447349238. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

300 KENTON DR
SUITE 100
CHARLESTON, WV
ZIP 25311-263
Phone: (304) 346-5533
Fax: (304) 346-5611

The provider's authorized official is Justin Dale Bailey .
The authorized official title is President and has the following contact phone number (304) 346-5533.

The CLIA number assigned to this NPI record is 51D0961757 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2006 and was last updated on 11/5/2015.


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
1207R00000XInternal Medicine20410WEST 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
11447349238OTHERWEST VIRGINIANPI NUMBER FOR THE GROUP
2P00189318OTHERWEST VIRGINIAUMWA PIN NUMBER FOR THE GROUP
3M09348961MEDICARE PINWEST VIRGINIA
4DC7713OTHERWEST VIRGINIAUMWA NUMBER FOR THE GROUP
5P00215125OTHERWEST VIRGINIARAILROAD NUMBER FOR THE GROUP
6001706175OTHERWEST VIRGINIABLUE CROSS NUMBER FOR THE GROUP
73810001081MEDICAIDWEST VIRGINIA
8Y21949MEDICARE UPIN

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.