KYLE F FORT (NPI# 1578559696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578559696 |
| Entity Type | Individual |
| Full Name | KYLE F FORT |
| Credential | MD |
| Practice Address |
1521 Maplewood Ave Ronceverte WV 24970-8026 |
| Mailing Address |
176 Dawkins Dr Lewisburg WV 24901-9302 |
| Practice Telephone | 3046475642 |
| Practice Fax Number | 3046475708 |
| Mailing Telephone | 3046474411 |
| Mailing Fax Number | 3046475708 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 13512 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 007500513 | 05 | |
| WV | 0131032000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 302 Carriage Dr, Beckley, WV 258012812 | 3046475642 |
| Street Address |
1521 MAPLEWOOD AVE |
| City | RONCEVERTE |
| State | WV |
| Zip Code | 24970-8026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902231830 | Willie W Smith IIi | Physician Assistant | 1521 Maplewood Ave, Ronceverte, WV 24970-8026 | 2013-09-11 |
| 1225024342 | Joseph Mouchizadeh | Urology | 1521 Maplewood Ave, Ronceverte, WV 24970-8026 | 2005-09-23 |
| 1942296066 | Thomas S Kowalkowski | Urology | 1521 Maplewood Ave, Ronceverte, WV 24970-8026 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770197980 | Susan Linton | Technician | 3776 Holes Mill Rd, Ronceverte, WV 24970 | 2020-09-04 |
| 1417561143 | Lori Selene Pickler | Technician | 974 C.west Main St, Ronceverte, WV 24970 | 2020-09-01 |
| 1184237257 | Jotina Hamrick | Technician | 194 Sellers St. Apt.a, Ronceverte, WV 24970 | 2020-08-28 |
| 1871072066 | Blink, Inc. | Eyewear Supplier (Equipment, not the service) | 3942 David Stuart Road, Suite 1, Ronceverte, WV 24970 | 2018-08-09 |
| 1407233976 | Rocky Mountain Holdings, LLC | Ambulance | 584 Airport Road, Box 9 (hangar 4), Lewisburg, WV 24970 | 2015-05-04 |
| 1245500040 | Seneca Family Foot Care, Pllc | Podiatrist | 336 Seneca Trail, Ronceverte, WV 24970 | 2012-01-10 |
| 1922301035 | Dwan Shasta Hamons | Pharmacist | 180 Red Oaks Shopping Center, Ronceverte, WV 24970 | 2010-12-10 |
| 1427351840 | Xuan Le Berry | Pharmacist | 180 Red Oaks Shopping Ctr., Ronceverte, WV 24970 | 2010-12-07 |
| 1104129683 | James P Meadows | Pharmacist | 180 Red Oak Shopping Center, Ronceverte, WV 24970 | 2010-12-06 |
| 1891924676 | Blink, Inc. | Optometrist | 101 Davis Stuart Road, Ronceverte, WV 24970 | 2009-07-14 |
| Find all providers in zip 24970 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386630408 | Greenbrier Valley Urology Associates, Inc | Urology | 119 Maplewood Ave, Ronceverte, WV 24970-9737 | 2005-09-23 |
| 1225024342 | Joseph Mouchizadeh | Urology | 1521 Maplewood Ave, Ronceverte, WV 24970-8026 | 2005-09-23 |
| 1942296066 | Thomas S Kowalkowski | Urology | 1521 Maplewood Ave, Ronceverte, WV 24970-8026 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194153825 | Amjad H. Alwaal | Urology | 1115 20th St Ste 107, Huntington, WV 25703-0003 | 2013-10-15 |
| 1184062549 | Appalachian Regional Healthcare, Inc. | Urology | 407 Carriage Drive, Beckley, WV 25801 | 2013-06-07 |
| 1386981488 | Integrated Health Care Providers, Inc. | Urology | 707 Madison Avenue, Madison, WV 25130 | 2013-01-09 |
| 1477823060 | Steve Joseph Misak | Urology | 2118 Jefferson St, Bluefield, WV 24701-4708 | 2012-01-12 |
| 1639477284 | S Vyas Md Inc | Urology | 22 1/2 W 2nd Ave, Williamson, WV 25661-3506 | 2011-03-07 |
| 1992012728 | Ignacio H Luna Md Inc | Urology | 426 Eighth St., Suite 300, Glen Dale, WV 26038 | 2010-08-31 |
| 1083893648 | Rodney Dean Md Pllc | Urology | 432 Division St, South Charleston, WV 25309-1402 | 2007-10-31 |
| 1649496571 | Shozo Kurusu | Urology | 1313 Quarrier St, Charleston, WV 25301-6002 | 2007-04-18 |
| 1184757163 | Naeem Pervaiz, M.d., P.C. | Urology | 608 New Hope Rd Ste 1, Princeton, WV 24740-2287 | 2007-03-13 |
| 1558496489 | Rajendra K Jain Urology Inc | Urology | 2828 First Ave Suite 204, Huntington, WV 25702 | 2007-02-22 |
| Find all providers with the same taxonomy | ||||
| City | RONCEVERTE |
| Zip Code | 24970 |
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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.