MODI MEDICAL CORPORATION (NPI# 1528178076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528178076 |
| Entity Type | Organization |
| Organization Name | MODI MEDICAL CORPORATION |
| Practice Address |
4605 Maccorkle Ave Sw Ste 302 South Charleston WV 25309-1311 |
| Mailing Address |
40 Fairland Drive Nitro WV 25143 |
| Practice Telephone | 3042042430 |
| Practice Fax Number | 3043976740 |
| Mailing Telephone | 3042042430 |
| Mailing Fax Number | 3043976740 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-10-20 |
| Authorized Official Name | JIGNESH J MODI (PRESIDENT) |
| Authorized Official Telephone | 3042042430 |
| Authorized Official Credential | MD PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
19795 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PTAN | 9341491 | 01 | |
| WV | 0300025000 | 05 |
| Street Address |
4605 MACCORKLE AVE SW STE 302 |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063556074 | Jignesh Jashawant Modi | Internal Medicine | 4605 Maccorkle Ave Sw Ste 302, South Charleston, WV 25309-1311 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407824345 | Dragana Orlovic | Internal Medicine | 500 Poplar St Ste 201, South Charleston, WV 25309-1472 | 2006-03-08 |
| 1063556074 | Jignesh Jashawant Modi | Internal Medicine | 4605 Maccorkle Ave Sw Ste 302, South Charleston, WV 25309-1311 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114491792 | Mountainstate Infectious Disease, Pllc | Internal Medicine | 215 W Main St Ste B, Bridgeport, WV 26330-1888 | 2019-01-16 |
| 1669716833 | Wanetta Susie Matulis | Internal Medicine | 68 Quarry Rdg, Charleston, WV 25304-1051 | 2012-11-12 |
| 1174778583 | Badiaa El-imad | Internal Medicine | 527 Medical Park Dr Ste 204, Bridgeport, WV 26330-9009 | 2008-11-26 |
| 1942398235 | Fred T Kerns | Internal Medicine | 3100 Maccorkle Ave Se Ste 604, Charleston, WV 25304-1231 | 2006-10-11 |
| 1639124159 | Dino James Delaportas | Internal Medicine | 11 Point of Vw, Bridgeport, WV 26330 | 2006-05-23 |
| 1609842640 | Seyoum Daffo Bage | Internal Medicine | 800 Grand Central Mall Ste 10, Vienna, WV 26105-4100 | 2006-02-28 |
| 1154393148 | Robert Wesley Farr | Internal Medicine | 3100 Maccorkle Ave Se Ste 902, Charleston, WV 25304-1234 | 2006-02-03 |
| 1427516129 | Parkersburg Infectious Disease Pllc | Internal Medicine | 800 Grand Central Mall Ste 10, Vienna, WV 26105-4100 | 2019-03-12 |
| 1336657493 | City Hospital, Inc. | Internal Medicine | 207 E 5th Ave, Ranson, WV 25438-1613 | 2018-01-11 |
| 1962912808 | United Hospital Center, Inc. | Internal Medicine | 527 Medical Park Dr Ste 302, Bridgeport, WV 26330-9009 | 2017-10-05 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
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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.