Organization Active NPI

New Creek Family Medicine PLLC

  • Family Medicine Physician
  • Keyser, WV
National Provider Identifier
1013331396
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21506 Issued in WV
Legal business name
NEW CREEK FAMILY MEDICINE PLLC
Practice address
1234 New Creek Hwy
Keyser, WV 26726-9505
Phone
(304) 788-9320
Fax
(304) 788-9320
NPI assigned
Feb 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Scott Thomas, MDNPI 1013945278
Title
Phsician/Owner
Phone
(304) 788-9320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 21506 WV Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 57703 WV

Addresses

Primary practice location

1234 New Creek Hwy
Keyser, WV 26726-9505

Mailing address

1234 New Creek Hwy
Keyser, WV 26726-9505
Phone (304) 788-9320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140820002751 WV Part B Supplier - Clinic/Group Practice 6305064189 Receives reassigned benefits from 2 practitioners
Practice locations: Keyser, WV

National Provider Directory

National Provider Directory

Locations

1234 New Creek Hwy
Keyser, WV 26726
Phone (304) 788-9320

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1013331396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NEW CREEK HWY",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267269505",
            "telephone_number": "304-788-9320",
            "fax_number": "304-788-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NEW CREEK HWY",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267269505",
            "telephone_number": "304-788-9320",
            "fax_number": "304-788-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CREEK FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHSICIAN/OWNER",
        "authorized_official_telephone_number": "304-788-9320",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21506",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "57703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keyser, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.