INTEGRATED HEALTH CARE PROVIDERS, INC. (NPI# 1073529616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073529616 |
| Entity Type | Organization |
| Organization Name | INTEGRATED HEALTH CARE PROVIDERS, INC. |
| Other Organization Name | DAVID LEE CANCER CENTER |
| Practice Address |
3100 Maccorkle Ave Se Ste 101 Charleston WV 25304-1215 |
| Mailing Address |
415 Morris St Ste 304 Charleston WV 25301-1853 |
| Practice Telephone | 3043888380 |
| Mailing Telephone | 3043887783 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-12-14 |
| Authorized Official Name | JEFF GOODE (PRESIDENT) |
| Authorized Official Telephone | 3043887783 |
| Authorized Official Credential | PT, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810006525 | 05 |
| Other Name | Type Code |
|---|---|
| David Lee Cancer Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003253709 | Integrated Health Care Providers, Inc. | Psychiatry & Neurology | 1208 Hospital Drive, Hurricane, WV 25526 | 2013-06-04 |
| 1386981488 | Integrated Health Care Providers, Inc. | Urology | 707 Madison Avenue, Madison, WV 25130 | 2013-01-09 |
| 1477890630 | Integrated Health Care Providers, Inc. | Internal Medicine | 73 E 3rd Ave, Williamson, WV 25661-3530 | 2013-01-08 |
| 1154688141 | Integrated Health Care Providers, Inc. | Internal Medicine | 556 S Main St, Chapmanville, WV 25508-5001 | 2012-04-16 |
| 1730473026 | Integrated Health Care Providers, Inc. | Orthopaedic Surgery | 1399 Hospital Dr, Hurricane, WV 25526-8709 | 2011-06-03 |
| 1528390366 | Integrated Health Care Providers, Inc. | Internal Medicine | 223 Maplewood Ave, Lewisburg, WV 24901-9459 | 2010-02-04 |
| 1225243785 | Integrated Health Care Providers, Inc. | Orthopaedic Surgery | 3703 Teays Valley Road, Hurricane, WV 25526-9645 | 2007-05-10 |
| 1699873240 | Integrated Health Care Providers, Inc. | Clinical Medical Laboratory | 830 Pennsylvania Ave Ste 205, Charleston, WV 25302-3389 | 2006-09-20 |
| 1982702528 | Integrated Health Care Providers, Inc. | Internal Medicine | 3100 Maccorkle Ave Se Ste 903, Charleston, WV 25304-1276 | 2006-09-20 |
| 1659489383 | Integrated Health Care Providers, Inc. | Emergency Medicine | 130 Goff Mountain Road, Cross Lanes, WV 25313 | 2006-08-25 |
| Street Address |
3100 MACCORKLE AVE SE STE 101 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154809341 | Audra E. Praskwiecz | Nurse Practitioner | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1215 | 2018-07-31 |
| 1386121374 | Monica Gene Higginbotham | Nurse Practitioner | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1215 | 2018-07-23 |
| 1770085946 | Kaitlynn Marie Cottrill | Nurse Practitioner | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1215 | 2018-03-05 |
| 1821500794 | John C. Caldwell | Nurse Practitioner | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1215 | 2017-10-31 |
| 1205122579 | Lavinia Petruta Mitulescu | Internal Medicine | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1281 | 2011-06-24 |
| 1932309291 | Sangeeta Mandapaka | Internal Medicine | 3100 Maccorkle Ave Se Ste 101, Charleston, WV 25304-1215 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689080129 | Gregory Michael Haidemenos | Internal Medicine | 169 Ashley Ave # Msc322, Charleston, SC 29425-8908 | 2014-07-04 |
| 1558507848 | Shelly Christiansen Shand | Internal Medicine | 2085 Henry Tecklenburg Dr Fl 2, Charleston, SC 29414 | 2008-12-17 |
| 1033147186 | Michael Brian Lilly | Internal Medicine | 39 Sabin Street, 725 Walton Bldg, Charleston, SC 29425 | 2006-06-29 |
| 1093773657 | George Frederick Geils Jr. | Internal Medicine | 2085 Henry Tecklenburg Dr, Second Floor, Charleston, SC 29414-7710 | 2006-05-03 |
| 1487611505 | George Paul Keogh | Internal Medicine | 125 Doughty Street, Suite 500, Charleston, SC 29403 | 2006-05-01 |
| 1790765212 | Robert M Silgals | Internal Medicine | 9295 -c Medical Plaza Dr, Charleston, SC 29406-9137 | 2006-01-19 |
| 1942285093 | Julia Margarita Cruz | Internal Medicine | 3110 Maccorkle Ave Se, Charleston, WV 25304-1210 | 2005-12-13 |
| 1619979416 | Daniel York Reuben | Internal Medicine | 173 Ashley Ave Ste 104, Msc 635, Charleston, SC 29425-8908 | 2005-08-11 |
| 1366446759 | Robert M. Silgals | Internal Medicine | 9295 - C Medical Plaza Dr, Charleston, SC 29406-9137 | 2005-06-13 |
| 1407232978 | Kelly Christina Burtch | Internal Medicine | 2085 Henry Tecklenburg Dr Fl 2, Charleston, SC 29414-7710 | 2015-08-06 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
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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.