120 Medical Park Dr, Suite 200, Bridgeport, WV 26330
Phone
(304) 624-7200
Listed under
Practices and organizations
NPI
1891892097
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Dermatology (207N00000X)
NPI first issued
Sep 20, 2006
Years since NPI first issued
20 years (since 2006)
NPI record last updated
Mar 14, 2025
Medicare group enrollment (CMS)
Enrolled: listed in CMS Doctors & Clinicians as Mountain State Medical Specialties PLLC
Clinicians in the Medicare group (all specialties, CMS)
28
Dermatology clinicians in the group at this ZIP (CMS)
4
Group Medicare assignment (CMS)
Accepts the Medicare-approved amount as payment in full
Other dermatology listings at this street address
3
NPI 1891892097 is active in the federal NPPES registry (CMS) with Dermatology as its self-reported primary taxonomy. CMS Doctors & Clinicians lists a Medicare-enrolled group with this name at this ZIP. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.
Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Dermatologist Index does not vet, employ, recommend or guarantee dermatology practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Dermatologist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error
What these registry facts mean
The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. To check board certification, use the American Board of Dermatology's verification tool (or the American Osteopathic Board of Dermatology for DOs), and confirm the medical license with the state board.
Dermatology clinicians and practices at this address
Other listings in this directory whose NPI record gives the same street address and ZIP. A shared address usually means a shared practice or building; it does not by itself show who works with whom.
Registered specialty is not board certification. Verify the license with the state medical board and board certification with the American Board of Dermatology or the American Osteopathic Board of Dermatology. Ask whether the practice takes your insurance or Medicare plan before you book.