Putnam Family Practice Associates Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14044 Issued in WV

Legal business name

PUTNAM FAMILY PRACTICE ASSOCIATES INC.

Practice address

3952 Teays Valley Rd
Hurricane, WV 25526-8728

Phone

(304) 757-6736

Fax

(304) 757-0582

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Randall Watson Peterson, M.D.

Title

President

Phone

(304) 757-6736

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1114062031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268728",
            "telephone_number": "304-757-6736",
            "fax_number": "304-757-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3952 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268728",
            "telephone_number": "304-757-6736",
            "fax_number": "304-757-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM FAMILY PRACTICE ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "WATSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-757-6736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "14044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057148000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (INDIVIDUAL)",
            "identifier": "1184694739",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Progressive Perspectives PLLC
• Emma Pruzan, PHARMD
• Vickie Hinzman Pullins
• Putnam Care and Rehabilitation
• Putnam Chiropractic Center
• Putnam Medical Group Inc
• Ty Danielle Quentrill, LPN
• Andrew McCaskey Quinlan, LAT, ATC
• Brent Thompson Race
• Jessica D Raines

• Family Medicine Physician in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.