NPIMap

Organization Active NPI

Oakwood Clinic Family Practice Inc

  • Family Medicine Physician
  • Wheeling, WV
National Provider Identifier
1184772568
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11364 Issued in WV
Legal business name
OAKWOOD CLINIC FAMILY PRACTICE INC
Practice address
616 Fairmont Pike RT88
Wheeling, WV 26003
Phone
(304) 242-3550
Fax
(304) 242-5810
NPI assigned
Jan 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas George Wack Jr., MDNPI 1497803878
Title
President
Phone
(304) 242-3550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11364 WV Primary

Addresses

Primary practice location

616 Fairmont Pike RT88
Wheeling, WV 26003

Mailing address

616 Fairmont Pike RT 88
PO Box 2286
Wheeling, WV 26003
Phone (304) 242-3500

Other identifiers 1

IdentifierTypeStateIssuer
0009097000MedicaidWV

National Provider Directory

National Provider Directory

Locations

616 Fairmont Pike Rd
Wheeling, WV 26003
Phone (304) 242-3049

616 Fairmont Pike Rd
#88
Wheeling, WV 26003
Phone (304) 242-3550

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184772568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FAIRMONT PIKE RT 88",
            "address_2": "PO BOX 2286",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-242-3500",
            "fax_number": "304-242-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 FAIRMONT PIKE RT88",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-242-3550",
            "fax_number": "304-242-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD CLINIC FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-242-3550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009097000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.