Fairway Primary Care, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS010770L Issued in PA

Legal business name

FAIRWAY PRIMARY CARE, LLC

Practice address

2950 Fairway Dr
Suite 2
Altoona, PA 16602-4457

Phone

(814) 942-9494

Fax

(814) 942-4399

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Miss Melissa Ann Kifer

Title

Office Coordinator

Phone

(814) 942-9494

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emeil Shenouda

  • Family Medicine Physician
  • McKeesport, PA
  • NPI 1215916986
  NPD (past)
• Regina W. Smith, D.O.

  • Internal Medicine Physician
  • Mechanicsburg, PA
  • NPI 1750360418
  NPD (past)
• Jojo E. Joves, MD

  • Internal Medicine Physician
  • Elk Grove, CA
  • NPI 1356429070
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1225169733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 FAIRWAY DR",
            "address_2": "SUITE 2",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024457",
            "telephone_number": "814-942-9494",
            "fax_number": "814-942-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 FAIRWAY DR",
            "address_2": "SUITE 2",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024457",
            "telephone_number": "814-942-9494",
            "fax_number": "814-942-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "KIFER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "814-942-9494",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS010770L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB9443",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyshia Louise Evans, RN, CRNP
• Jill Evans
• Evolution Alternative Physical Therapy & Wellness Studio LLC
• Evolution Counseling Services, LLC
• Eyedoc Associates, LLC
• Mildred Therese Fajardo, M.D.
• Family Services Incorporated
• Megan Fanella
• Bethany J Farabaugh, LSW
• Clement Farabaugh, CRNA

• Internal Medicine Physician in Altoona, PA
• Providers in Altoona, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.