CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC NPI 1003017823

Internal Medicine (Nephrology) in South Charleston, WV

NPI 1003017823 Organization Internal Medicine Nephrology CLIA Number 51D1074475 CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP)

About CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC

Charleston Nephrology Hypertension And Transplant, Pllc is an internal medicine provider established in South Charleston, West Virginia specializing in internal medicine (nephrology) . The NPI number of Charleston Nephrology Hypertension And Transplant, Pllc is 1003017823 and was assigned on May 2007. The practitioner's primary taxonomy code is 207RN0300X with license number 22697 (WV). The provider is registered as an organization and their NPI record was last updated one year ago. Charleston Nephrology Hypertension And Transplant, Pllc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Abdul Rahman Zanabli M.d. (Medical Director)

An internist like Charleston Nephrology Hypertension And Transplant, Pllc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

The CLIA number of Charleston Nephrology Hypertension And Transplant, Pllc is 51D1074475 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Charleston Nephrology Hypertension And Transplant, Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI

1003017823

Provider NameCHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC
Provider Location Address4825 MACCORKLE AVE SW SUITE A SOUTH CHARLESTON, WV 25309
Provider Mailing Address4825 MACCORKLE AVE SW SUITE A SOUTH CHARLESTON, WV 25309
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-30-2007
Last Update Date06-16-2020


Primary Taxonomy

Taxonomy Code207RN0300X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationNephrology
License No.22697
License StateWV
Taxonomy DescriptionAn internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Business Address

CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC
4825 MACCORKLE AVE SW
SUITE A
SOUTH CHARLESTON, WV
ZIP 25309
Phone: (304) 400-4700
Fax: (304) 693-2606

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Mailing Address

CHARLESTON NEPHROLOGY HYPERTENSION AND TRANSPLANT, PLLC
4825 MACCORKLE AVE SW
SUITE A
SOUTH CHARLESTON, WV
ZIP 25309
Phone: (304) 400-4700
Fax: (304) 693-2606



Authorized Official

Authorized Official NameDR. ABDUL RAHMAN ZANABLI M.D.
Authorized Official TitleMEDICAL DIRECTOR
Authorized Official Phone(304) 400-4700

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003017823 is:

CLIA Number51D1074475
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate for Provider-Performed Microscopy Procedures (PPMP)

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
3810010603MEDICAID (05)WV
001953144OTHER (01)WV

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1124108006MR. WALTER ANDREW COUNTS M.A., L.P.C.
Individual
Counselor (Professional)4825 MACCORKLE AVE SW SUITE D
SOUTH CHARLESTON, WV 25309
(304) 766-4583
1003987199MS. PAULETTE SUSAN JUSTICE LPC, LCSW
Individual
Counselor (Professional)4825 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25309
(304) 766-4572
1790028744HERBERT J. THOMAS MEMORIAL HOSPITAL ASSOCIATION
Organization
Clinic/Center (Mental Health (Including Community Mental Health Center))4825 MACCORKLE AVE SW SUITE D
SOUTH CHARLESTON, WV 25309
(304) 766-4560

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.