Brian Powderly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14380 Issued in WV

Practice address

2675 36TH St
Parkersburg, WV 26104-8024

Phone

(304) 422-8112

Fax

(304) 422-3924

NPI assigned

Mar 2, 2006

Reactivated

Jul 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brian Powderly MD

  • Family Medicine Physician
  • Parkersburg, WV
  • NPI 1891833570
  NPD (past) Authorized official

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1134196835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SAINT ANDREWS BLVD",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457149327",
            "telephone_number": "304-422-8112",
            "fax_number": "304-422-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 36TH ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261048024",
            "telephone_number": "304-422-8112",
            "fax_number": "304-422-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWDERLY",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "deactivation_date": "2021-07-26",
        "reactivation_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "14380",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35076176P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125417",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BCBS",
            "identifier": "000147520",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057420000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110019344",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lilia Ponce, MA
• Martine Rhea Pool
• Jenna Poole
• Rochelle Popovich, NP-C
• Misty Potter
• Brianna Leigh Powell
• Jay Powell, MA CCC-SLP
• Megan Powell
• Tiffany Powell
• Elizabeth S Powers, M.D.

• Family Medicine Physician in Parkersburg, WV
• Providers in Parkersburg, 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 Jul 13, 2023; 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.