NPIMap

Organization Active NPI

Kingwood Family Care, LLC

  • Primary Care Clinic/Center
  • Kingwood, WV
National Provider Identifier
1306330345
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
UD000764150001 Issued in WV
Legal business name
KINGWOOD FAMILY CARE, LLC
Practice address
17548 Veterans Memorial Highway
Suite D
Kingwood, WV 26537
Phone
(304) 441-2001
Fax
(304) 441-2009
NPI assigned
Jun 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Robert Goodwin Jr.
Title
Owner
Phone
(304) 319-1825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X UD000764150001 WV Primary

Addresses

Primary practice location

17548 Veterans Memorial Highway
Suite D
Kingwood, WV 26537

Mailing address

17548 Veterans Memorial Highway
Suite D
Kingwood, WV 26537
Phone (304) 441-2001

National Provider Directory

National Provider Directory

Locations

17548 Veterans Memorial Hwy
Ste D
Kingwood, WV 26537
Phone (304) 441-2001

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1306330345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17548 VETERANS MEMORIAL HIGHWAY",
            "address_2": "SUITE D",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "26537",
            "telephone_number": "304-441-2001",
            "fax_number": "304-441-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17548 VETERANS MEMORIAL HIGHWAY",
            "address_2": "SUITE D",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "26537",
            "telephone_number": "304-441-2001",
            "fax_number": "304-441-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGWOOD FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-319-1825",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "UD000764150001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.