MEDEXPRESS URGENT CARE, PLLC - CHARLESTON (NPI# 1740448430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740448430 |
| Entity Type | Organization |
| Organization Name | MEDEXPRESS URGENT CARE, PLLC - CHARLESTON |
| Practice Address |
5430 Maccorkle Ave Se Charleston WV 25304-2224 |
| Mailing Address |
Po Box 719 Dellslow WV 26531-0719 |
| Practice Telephone | 3049253627 |
| Practice Fax Number | 3049251163 |
| Mailing Telephone | 3049853627 |
| Mailing Fax Number | 3049853630 |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2012-02-13 |
| Authorized Official Name | TIMOTHY BUGIN (VP OF PAYOR CONTRACTING) |
| Authorized Official Telephone | 3042252500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
01026 | WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | CLIA | 51D1089045 | 01 |
| WV | 3810012430 | 05 |
| Street Address |
5430 MACCORKLE AVE SE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-2224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659349405 | Sidney Alan Humphrey | Physician Assistant | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2006-03-09 |
| 1578936712 | Tyler Fisher | Physician Assistant | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2015-11-10 |
| 1568832996 | Ashley Mueller | Physician Assistant | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2015-09-28 |
| 1316325053 | Kimberly D Slater | Physician Assistant | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2015-05-14 |
| 1760892020 | Benjamin Charles Cook | Family Medicine | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2014-05-07 |
| 1649540899 | Medexpress Urgent Care, Inc - West Virginia | Emergency Medicine | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2012-01-05 |
| 1588947097 | Ashley Marie Dolan | Physician Assistant | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2011-09-21 |
| 1629359534 | Carla Saunders | Physician Assistant | 5430 Maccorkle Ave Se, Charleston, WV 25304-2224 | 2011-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457579617 | Medcare Express - North Charleston LLC | Clinic/Center | 1850 Sam Rittenberg Blvd, Suite B, Charleston, SC 29407-4936 | 2007-04-23 |
| 1497771919 | Express Medical Care | Clinic/Center | 2049 Savannah Hwy, Suite D, Charleston, SC 29407-2228 | 2006-07-15 |
| 1164805545 | Medcare Express North Charleston | Clinic/Center | 1850 Sam Rittenberg Blvd, Suite B, Charleston, SC 29407-4936 | 2015-07-03 |
| 1689972739 | Nason Medical Center Iv, LLC | Clinic/Center | 319 Folly Rd, Charleston, SC 29412-2518 | 2011-03-14 |
| 1457655474 | Medcare Urgent Care Center, W. Ashley LLC | Clinic/Center | 1850 Sam Rittenberg Blvd, Suite B, Charleston, SC 29407-4936 | 2011-01-05 |
| 1831416346 | St. Andrews Urgent Care, PC | Clinic/Center | 975 Savannah Hwy, Suite 105, Charleston, SC 29407-7859 | 2010-04-23 |
| 1225215429 | American Current Care Pa | Clinic/Center | 4115 Dorchester Road, Charleston, SC 29405 | 2008-01-30 |
| 1861693194 | Integrated Health Care Providers, Inc. | Clinic/Center | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2007-05-31 |
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|---|---|---|---|---|
| 1043727787 | University Healthcare Physicians, Inc. | Clinic/Center | 61 Campus Dr, Martinsburg, WV 25404 | 2018-01-03 |
| 1417390154 | Fayette Medical Services Pllc | Clinic/Center | 5447 Maple Ln Ste B, Fayetteville, WV 25840-6872 | 2013-04-11 |
| 1699027714 | Eastern Div-ranson Urgent Care | Clinic/Center | 203 East Fourth Avenue Suite B, Ranson, WV 25438-1617 | 2012-10-12 |
| 1841564622 | Preston Memorial Medical Group | Clinic/Center | 27 N Robert Stone Way, Reedsville, WV 26547-7314 | 2012-02-27 |
| 1407180888 | Valeo Medical, Pllc | Clinic/Center | 260 Russell Ave, 260 Russell Ave, New Martinsville, WV 26155-1571 | 2009-10-01 |
| 1235316027 | Convenience Clinics of America, Inc | Clinic/Center | 2107 Pike St Ste 5, Parkersburg, WV 26101-6973 | 2008-01-24 |
| 1699814020 | Mountain Medical PC, LLC | Clinic/Center | 747 N Main St, Suite C, Moorefield, WV 26836-1020 | 2007-02-05 |
| 1730262668 | Snowshoe Mountain Inc. | Clinic/Center | 10 Snowshoe Dr., Snowshoe, WV 26209 | 2006-10-23 |
| 1992726236 | Jefferson Urgent Care, LLC | Clinic/Center | 84 Somerset Blvd, Charles Town, WV 25414-4827 | 2006-07-22 |
| 1013960632 | Medbrook Medical Associates Inc | Clinic/Center | 1370 Johnson Avenue, Bridgeport, WV 26330-1382 | 2006-05-17 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
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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.