MODERN MEDICINE INC (NPI# 1942256821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942256821 |
| Entity Type | Organization |
| Organization Name | MODERN MEDICINE INC |
| Practice Address |
4114 1st Ave Nitro WV 25143 |
| Mailing Address |
4114 1st Ave Nitro WV 25143-1304 |
| Practice Telephone | 3047550119 |
| Practice Fax Number | 3047550111 |
| Mailing Telephone | 3047550119 |
| Mailing Fax Number | 3047550111 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-04-19 |
| Authorized Official Name | ELIAS HAIKAL (PRESIDENT) |
| Authorized Official Telephone | 3047550119 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 11111 | WV | Suppliers |
| Y | 207Q00000X | Family Medicine | 1111 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | DME MAC | 6604540001 | 01 |
| WV | 0055458000. | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407095326 | Modern Medicine Inc | Chiropractor | 5458 Town Center Rd Ste 104, Boca Raton, FL 33486-1026 | 2009-02-17 |
| 1336487222 | Modern Medicine Inc | Anesthesiology | 8700 Warner Ave Ste 200, Fountain Valley, CA 92708-3212 | 2013-01-28 |
| Street Address |
4114 1ST AVE |
| City | NITRO |
| State | WV |
| Zip Code | 25143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639537 | Regina Alford | Technician | 640 Cross Lanes Dr. Apt #6, Nitro, WV 25143 | 2020-11-03 |
| 1831677061 | Amy Bateman | Pharmacist | Fruth Pharmacy Patient Care Center, 106 21st Street, Nitro, WV 25143 | 2018-07-31 |
| 1033617543 | Anne Dean | Technician | 3306 3rd St, Nitro, WV 25143 | 2018-01-30 |
| 1720506363 | Philip Neil Kennedy II | Pharmacist | 106 21st Street, Nitro, WV 25143 | 2017-09-05 |
| 1326373705 | Laurie Jewel Elkins | Nurse Anesthetist, Certified Registered | 905 Washington Avenue, Nitro, WV 25143 | 2009-10-02 |
| 1588826515 | Rachel Heilmann | Pharmacist | 113 Norwood Drive, Nitro, WV 25143 | 2008-07-01 |
| 1326140922 | Terry Lee Mcwatters | Dentist | 2201 22nd Street, Nitro, WV 25143 | 2006-09-02 |
| 1962455261 | Eye Doc Inc | Optometrist | 100 Nitro Marketplace, Nitro, WV 25143 | 2006-05-18 |
| 1639665912 | Damous Center | Clinic/Center | 234 Lee Ave, Nitro, WV 25143 | 2018-07-10 |
| 1972808012 | Sizewise Rentals LLC | Durable Medical Equipment & Medical Supplies | 4200 1st Ave, Suite 109, Nitro, WV 25143 | 2011-01-21 |
| Find all providers in zip 25143 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134199243 | Gregory Mark Moreland | Family Medicine | 2206 22nd St, Nitro, WV 25143-1729 | 2006-01-23 |
| 1073058947 | Joseph Zachary Wiley | Family Medicine | 4111 1st Ave Ste 3, Nitro, WV 25143-1345 | 2016-12-30 |
| 1154592582 | G. Mark Moreland M.d. | Family Medicine | 2206 22nd St, Nitro, WV 25143-1729 | 2008-03-13 |
| 1518037845 | Nitro Primary Care | Family Medicine | 4111 1st Ave, Nitro, WV 25143-1304 | 2006-11-08 |
| 1033297445 | E Michael Robie | Family Medicine | 4111 1st Ave, #3, Nitro, WV 25143-1304 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652868 | Grace Health Care Pllc | Family Medicine | 223 5th Ave, Huntington, WV 25701-1809 | 2020-09-02 |
| 1356954259 | Relymd Medical Group Wv, Pllc | Family Medicine | 1627 Quarrier St, Charleston, WV 25311-2124 | 2020-08-28 |
| 1174133243 | Jacqulyn Marie Sheppard | Family Medicine | 2647 Raceview Dr, Ona, WV 25545-9636 | 2020-08-04 |
| 1194341594 | E. A. Hawse Health Center, Inc. | Family Medicine | Romney Elementary School, 45 School Street, Romney, WV 26757 | 2020-06-22 |
| 1730705328 | E. A. Hawse Health Center, Inc. | Family Medicine | Romney Middle School, 296 Calvert Drive, Romney, WV 26757 | 2020-06-19 |
| 1437775251 | E. A. Hawse Health Center, Inc. | Family Medicine | Hampshire High School, 157 Trojan Way, Romney, WV 26757-6317 | 2020-06-17 |
| 1235753286 | Community Health Association | Family Medicine | 146 Pinnell St, Ripley, WV 25271-9101 | 2020-06-05 |
| 1871114546 | Family Care Plus Pllc | Family Medicine | 320 Red Oaks Shopping Ctr, Ronceverte, WV 24970-1364 | 2020-05-04 |
| 1073142733 | Total Health and Recovery Clinic, LLC | Family Medicine | 1824 Murdoch Ave Bldg F Suite201, Parkersburg, WV 26101-3230 | 2020-04-05 |
| 1437780269 | Healthcare 360 Pllc | Family Medicine | 208 Dawkins Drive, Lewisburg, WV 24901 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
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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.