Organization Active NPI

Spectrum Family Care, PLLC

  • Family Medicine Physician
  • Hurricane, WV
National Provider Identifier
1194045237
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPECTRUM FAMILY CARE, PLLC
Practice address
1401 Hospital Dr
Suite 306
Hurricane, WV 25526-9237
Phone
(304) 397-5744
Fax
(304) 757-0964
NPI assigned
Jun 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Authorized official

Name
Angela D Sizemore
Title
Business Office Director
Phone
(304) 397-5744

Specialties & licenses 1

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

Addresses

Primary practice location

1401 Hospital Dr
Suite 306
Hurricane, WV 25526-9237

Mailing address

1401 Hospital Dr
Suite 306
Hurricane, WV 25526-9237
Phone (304) 397-5744

Other identifiers 1

IdentifierTypeStateIssuer
3810018383MedicaidWV

National Provider Directory

National Provider Directory

Locations

600 Prestige Park Dr
#A1
Hurricane, WV 25526
Phone (304) 760-8843

1401 Hospital Dr
Ste 306
Hurricane, WV 25526
Phone (304) 397-5744

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1194045237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HOSPITAL DR",
            "address_2": "SUITE 306",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269237",
            "telephone_number": "304-397-5744",
            "fax_number": "304-757-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HOSPITAL DR",
            "address_2": "SUITE 306",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269237",
            "telephone_number": "304-397-5744",
            "fax_number": "304-757-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM FAMILY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "SIZEMORE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "304-397-5744"
    },
    "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": "3810018383",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.