Justice Medical Complex

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21730 Issued in WV

Legal business name

JUSTICE MEDICAL COMPLEX

Practice address

RR Box 330 US Hwy 52
Kermit, WV 25669

Phone

(304) 393-4004

Fax

(304) 393-4167

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra Justice

Title

Owner

Phone

(304) 393-4004

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 4

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.

• John T Tiano, MD

  • Cardiovascular Disease Physician
  • Logan, WV
  • NPI 1265517858
  NPD (past)
• Augusto T Abad, M.D.

  • Specialist
  • South Williamson, KY
  • NPI 1972547339
  NPD (past)
• Deborah Lynn Hatfield, ARNP

  • Family Nurse Practitioner
  • Lexington, KY
  • NPI 1225022411
  NPD (past)
• Violet R Vance, ARNP

  • Family Nurse Practitioner
  • South Williamson, KY
  • NPI 1770781841
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356426944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 837",
            "city": "KERMIT",
            "state": "WV",
            "postal_code": "256740837",
            "telephone_number": "304-393-4004",
            "fax_number": "304-393-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR BOX 330 US HWY 52",
            "city": "KERMIT",
            "state": "WV",
            "postal_code": "25669",
            "telephone_number": "304-393-4004",
            "fax_number": "304-393-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTICE MEDICAL COMPLEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-393-4004"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65944621",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004168",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Haydu
• Estella Hinkle
• Hannah Hinkle
• Miranda Kay Hodge
• Leslie Hunt
• Marlena Kirk
• Crystal Gail Krimm, MPT
• Morgan Brooks Leffel
• Candace Marcum
• Elaine Marcum

• Family Medicine Physician in Kermit, WV
• Providers in Kermit, WV by specialty
• Family Medicine Physician in West Virginia

• 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.