DOCTORS SPECIALTY CARE (NPI# 1285013896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285013896 |
| Entity Type | Organization |
| Organization Name | DOCTORS SPECIALTY CARE |
| Other Organization Name | ADDICTION CENTER OF WV |
| Practice Address |
27 Trovato St Suite Number 103 Bridgeport WV 26330-7002 |
| Mailing Address |
27 Trovato St Suite Number 103 Bridgeport WV 26330 |
| Practice Telephone | 3046236300 |
| Practice Fax Number | 3046236302 |
| Mailing Telephone | 3046236300 |
| Mailing Fax Number | 3046236302 |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |
| Authorized Official Name | DR. THOMAS LAUDERMAN (OWNER) |
| Authorized Official Telephone | 3046236300 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Addiction Center of WV | Doing Business As Name - Organization |
| Street Address |
27 TROVATO ST SUITE NUMBER 103 |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-7002 |
| 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 | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972943785 | Phillip Bradley Hall | Family Medicine | 680 Genesis Blvd, Ste 201, Bridgeport, WV 26330-9135 | 2013-06-26 |
| 1205473725 | Applegate Health Services, Inc | Family Medicine | 27 Trovato St Ste 103, Bridgeport, WV 26330-7286 | 2019-12-03 |
| 1275608879 | Christina Kolade | Family Medicine | 3851 Main St, Bridgeport, CT 06606-2864 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750995734 | Sarah Nicole Stanley | Family Medicine | 31 Sandlewood Dr, Beckley, WV 25801-2358 | 2020-09-07 |
| 1942847975 | Recovery Care LLC | Family Medicine | 37 Carroll Avenue, Keyser, WV 26726 | 2019-12-10 |
| 1316438773 | Road To Recovery, LLC | Family Medicine | 111 Court St S, Ripley, WV 25271 | 2018-05-22 |
| 1356841100 | Harper Road Treatment Center LLC | Family Medicine | 1802 Harper Rd Ste 202, Beckley, WV 25801 | 2018-02-19 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1316354574 | New Lifeclinics Inc | Family Medicine | 3471 Ohio River Rd, Point Pleasant, WV 25550-4401 | 2014-07-18 |
| 1861829947 | Hamada E Mahmoud | Family Medicine | 5505 Us Route 60 East, Suite 175, Huntington, WV 25705-2058 | 2013-10-03 |
| 1336413335 | Rodney Michael Simpkins | Family Medicine | 131 Moorefield Pl, Scott Depot, WV 25560-9565 | 2012-03-08 |
| 1003070194 | Emad Y Mousa | Family Medicine | 77 Hospital Dr Ste 200, Logan, WV 25601-3451 | 2008-07-17 |
| 1194338244 | Envision Medical Care, LLC | Family Medicine | 111 Court St S, Ripley, WV 25271-1408 | 2020-08-28 |
| 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.