PEDIATRIC ASSOCIATE (NPI# 1104937416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104937416 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ASSOCIATE |
| Practice Address |
11 Chenoweth Dr Suite A Bridgeport WV 26330-1675 |
| Practice Telephone | 3048425777 |
| Practice Fax Number | 3048423318 |
| Mailing Telephone | 3048425777 |
| Mailing Fax Number | 3048423318 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOSEPH MOMEN (OWNER) |
| Authorized Official Telephone | 3048425777 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | WV11941 | WV | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0010556000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538256805 | Pediatric Associate | Clinical Medical Laboratory | 11 Chenoweth Dr, Suite A, Bridgeport, WV 26330-1675 | 2006-10-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PEDIATRIC ASSOCIATES FOR LANGUAGE AND SPEECH, PLLC | 333 West 57th St., Ste 107, New York, Ny 10019 |
| Massachusetts Corporations | PEDIATRIC ASSOCIATES INC. OF BROCKTON | 370 Oak Street, Brockton, MA 02301 |
| Iowa Business Entities | PEDIATRIC ASSOCIATES IOWA CITY BUILDING PARTNERSHIP LLP | 605 E Jefferson St, Iowa City, IA 52245 |
| Virginia Business Entities | PEDIATRIC ASSOCIATES OF ALEXANDRIA INC. | 6355 Walker Lane #401, Alexandria, Virginia 22310 |
| Virginia Business Entities | PEDIATRIC ASSOCIATES OF CHARLOTTESVILLE P.L.C. | 1011 E Jefferson St, Charlottesville, Virginia 22902 |
| Iowa Business Entities | PEDIATRIC ASSOCIATES OF CORALVILLE BUILDING PARTNERSHIP LLP | 605 E Jefferson St, Iowa City, IA 52245 |
| Colorado Business Entities | Pediatric Associates of Durango, Inc. | 29423 Highway 160, Durango, CO 81301 |
| Massachusetts Corporations | PEDIATRIC ASSOCIATES OF FALL RIVER, INC. | 851 Middle St., Fall River, MA 02721 |
| Massachusetts Corporations | PEDIATRIC ASSOCIATES OF FRANKLIN COUNTY, P.C. | 56 Main St., Turners Falls, MA 01376 |
| Oregon Corporations, Companies and Business Names | PEDIATRIC ASSOCIATES OF GRESHAM, P.C. | 2150 Ne Division St Ste 103, Gresham, OR 97030 |
| Street Address |
11 CHENOWETH DR SUITE A |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538256805 | Pediatric Associate | Clinical Medical Laboratory | 11 Chenoweth Dr, Suite A, Bridgeport, WV 26330-1675 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104037779 | Tarrant Plastic Surgery, Inc | Legal Medicine | 600 18th St Ste 310, Parkersburg, WV 26101-3235 | 2007-05-25 |
| 1013016336 | Sigal Levy Kuhl | Legal Medicine | 1359 Woodward Dr, Charleston, WV 25312-9505 | 2006-09-22 |
| 1093702698 | Dionisio E Policarpio | Legal Medicine | 209 Washington St W, Charleston, WV 25302-2345 | 2005-09-29 |
| 1477559524 | Paul Jakubec | Legal Medicine | 404 Inglewood Blvd, Morgantown, WV 26505-7316 | 2005-06-23 |
| 1629230230 | Jonathon B Murphy Md Inc | Legal Medicine | 201 6th Ave, Saint Albans, WV 25177-2836 | 2008-06-26 |
| 1679783716 | Frank J. Trupo | Legal Medicine | 331 Laidley St, Suite 510, Charleston, WV 25301-1619 | 2007-05-23 |
| 1023144458 | Internal Medicine of Bluefield, Pllc | Legal Medicine | 1331 Southview Dr, Suite 1, Bluefield, WV 24701-4320 | 2007-02-27 |
| 1043307572 | Princeton Pediatrics, P.C. | Legal Medicine | 216 New Hope Rd, Princeton, WV 24740-2135 | 2006-10-06 |
| 1528169695 | Princeton Pediatrics Lab | Legal Medicine | 216 New Hope Rd, Princeton, WV 24740-2135 | 2006-09-25 |
| 1437257441 | Charbrook Medico, P.C. | Legal Medicine | 510 Cherry St, Ste. 202, Bluefield, WV 24701-3338 | 2006-09-21 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
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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.