Active NPI
Brandy Lou Vannatter, DO
- Family Medicine Physician
- Madison, WV
National Provider Identifier
1184768392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2142
- Practice address
- 701 Madison Ave
Madison, WV 25130-1669 - Phone
- (304) 369-1230
- NPI assigned
- Feb 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2142 | WV | Primary |
Addresses
Primary practice location
701 Madison Ave
Madison, WV 25130-1669
Mailing address
810 Middle Horse Creek Rd
Julian, WV 25529-9617
Phone (304) 369-3050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2142 | WV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184768392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 MIDDLE HORSE CREEK RD",
"city": "JULIAN",
"state": "WV",
"postal_code": "255299617",
"telephone_number": "304-369-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 MADISON AVE",
"city": "MADISON",
"state": "WV",
"postal_code": "251301669",
"telephone_number": "304-369-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANNATTER",
"first_name": "BRANDY",
"middle_name": "LOU",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "2142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.