Organization Active NPI

Ohio Valley Medical Quickcare Inc

  • Family Medicine Physician
  • Marietta, OH
National Provider Identifier
1144218694
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OHIO VALLEY MEDICAL QUICKCARE INC
Practice address
324 Pike St
Marietta, OH 45750-3323
Phone
(740) 374-4540
Fax
(740) 374-3373
NPI assigned
Oct 10, 2005
Last updated
Feb 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Mr. Johnny D Jurado
Title
Business Manager
Phone
(304) 485-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

324 Pike St
Marietta, OH 45750-3323

Mailing address

417 Grand Park Dr
Ste 103
Parkersburg, WV 26105-4049
Phone (304) 485-2700

Other identifiers 2

IdentifierTypeStateIssuer
2208891MedicaidOH
0019701003MedicaidWV

National Provider Directory

National Provider Directory

Locations

324 Pike St
Marietta, OH 45750
Phone (304) 374-4540

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1144218694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 GRAND PARK DR",
            "address_2": "STE 103",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261054049",
            "telephone_number": "304-485-2700",
            "fax_number": "304-485-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 PIKE ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503323",
            "telephone_number": "740-374-4540",
            "fax_number": "740-374-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO VALLEY MEDICAL QUICKCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "JURADO",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "304-485-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208891",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019701003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.