NPIMap

Organization Active NPI

Par Wellness Corporation

  • Family Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1275585739
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1675 Issued in WV
Legal business name
PAR WELLNESS CORPORATION
Doing business as
Bridgeport Family Medicine
Practice address
1221 Johnson Ave
Suite 1100
Bridgeport, WV 26330-1392
Phone
(304) 848-0338
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Robert Paul Romano, DONPI 1982657334
Title
Owner
Phone
(304) 848-0338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1675 WV Primary

Addresses

Primary practice location

1221 Johnson Ave
Suite 1100
Bridgeport, WV 26330-1392

Mailing address

1221 Johnson Ave
Suite 1100
Bridgeport, WV 26330-1392
Phone (304) 848-0338

Other identifiers 2

IdentifierTypeStateIssuer
DF7112OtherWVRAILROAD MEDICARE
3810010298MedicaidWV

Other names 1

  • Bridgeport Family Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1275585739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 JOHNSON AVE",
            "address_2": "SUITE 1100",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301392",
            "telephone_number": "304-848-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 JOHNSON AVE",
            "address_2": "SUITE 1100",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301392",
            "telephone_number": "304-848-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAR WELLNESS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ROMANO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-848-0338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF7112",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010298",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.