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MOUNTAIN STATE ORTHOPEDICS AND SPORTS MEDICINE NPI 1831841675


NPI Information

NPI: 1831841675
Provider Name: MOUNTAIN STATE ORTHOPEDICS AND SPORTS MEDICINE
Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 51D2252134

Address:
4089W WEBSTER RD
SUMMERSVILLE, WV
ZIP 26651
Phone: (304) 900-2589
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MOUNTAIN STATE ORTHOPEDICS AND SPORTS MEDICINE is a sports medicine orthopaedic surgery in Summersville, WV. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. MOUNTAIN STATE ORTHOPEDICS AND SPORTS MEDICINE NPI is 1831841675. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4089W WEBSTER RD
SUMMERSVILLE, WV
ZIP 26651-682
Phone: (304) 900-2589
Fax: (800) 397-1586

The provider's authorized official is William R Carson .
The authorized official title is President and has the following contact phone number (304) 900-2589.

The CLIA number assigned to this NPI record is 51D2252134 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2022 and was last updated on 3/13/2024.


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
1207XX0005XOrthopaedic SurgerySports MedicineYes

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

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.