NPIMap

Organization Active NPI

Fast Track Anesthesia

Doing business as Fast Track Anestehsia

  • Specialist
  • Martinsburg, WV
National Provider Identifier
1063513653
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FAST TRACK ANESTHESIA
Doing business as
Fast Track Anestehsia
Practice address
1008 Tavern Rd
Martinsburg, WV 25401-2801
Phone
(304) 596-2378
Fax
(304) 596-2388
NPI assigned
Sep 26, 2006
Last updated
Mar 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Authorized official

Name
Mrs. Jessica Anne Palumbo, MD
Title
Owner
Phone
(304) 596-2387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1008 Tavern Rd
Martinsburg, WV 25401-2801

Mailing address

1008 Tavern Rd
Martinsburg, WV 25401-2801
Phone (304) 596-2378

Other identifiers 1

IdentifierTypeStateIssuer
3810002630MedicaidWV

Other names 1

  • FAST TRACK ANESTEHSIA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1063513653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012801",
            "telephone_number": "304-596-2378",
            "fax_number": "304-596-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012801",
            "telephone_number": "304-596-2378",
            "fax_number": "304-596-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST TRACK ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "PALUMBO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-596-2387",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002630",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAST TRACK ANESTEHSIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.