MOUNTAIN STATE MEDICAL SPECIALTIES,INC. (NPI# 1154747442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154747442 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATE MEDICAL SPECIALTIES,INC. |
| Practice Address |
120 Medical Park Dr Ste 101 Bridgeport WV 26330-9013 |
| Mailing Address |
125 N 6th St Clarksburg WV 26301-2665 |
| Practice Telephone | 3046247200 |
| Practice Fax Number | 3046240026 |
| Mailing Telephone | 3046247200 |
| Mailing Fax Number | 3046240026 |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |
| Authorized Official Name | EVELYN MCGEE (VP) |
| Authorized Official Telephone | 3046247200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | PTAN | MO 9307351 | 01 |
| Street Address |
120 MEDICAL PARK DR STE 101 |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-9013 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457610180 | Apsp-bridgeport, LLC | Clinical Medical Laboratory | 1905 Doctor's Hospital Drive, Doctor's Hospital, Bridgeport, TX 76246 | 2012-05-15 |
| 1154549095 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 4750 Main St, Bridgeport, CT 06606-1823 | 2007-04-24 |
| 1760968598 | Monitor My Health, Inc. | Clinical Medical Laboratory | 1000 Lafayette Blvd Ste 1100, Bridgeport, CT 06604-4710 | 2018-07-15 |
| 1366836066 | Fst Lab, LLC | Clinical Medical Laboratory | 48 Alpine St, Bridgeport, CT 06610-1727 | 2015-03-20 |
| 1457605404 | West Virginia University Medical Corporation | Clinical Medical Laboratory | 527 Medical Park Dr, Suite 108, Bridgeport, WV 26330-9008 | 2012-10-30 |
| 1851650832 | Oncology Hematology Associates Pllc | Clinical Medical Laboratory | 327 Medical Park Dr, Bridgeport, WV 26330-9006 | 2012-05-10 |
| 1619152436 | United Physicians Care Inc | Clinical Medical Laboratory | 1511 Johnson Ave, Ste 104, Bridgeport, WV 26330-1016 | 2007-12-31 |
| 1649395021 | Oncology Hematology Associates Lab | Clinical Medical Laboratory | 327 Medical Park Drive, Bridgeport, WV 26330-9006 | 2007-03-21 |
| 1578692679 | Medbrook Medical Assoc. Inc. | Clinical Medical Laboratory | 1370 Johnson Ave, Bridgeport, WV 26330-1382 | 2007-03-05 |
| 1538256805 | Pediatric Associate | Clinical Medical Laboratory | 11 Chenoweth Dr, Suite A, Bridgeport, WV 26330-1675 | 2006-10-06 |
| Find all providers in BRIDGEPORT | ||||
| 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.