NPIMap

Organization Active NPI

Robert J Fanning, Jr

  • Specialist
  • Wheeling, WV
National Provider Identifier
1376644625
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1431 Issued in WV
Legal business name
ROBERT J FANNING, JR
Practice address
1307 Mount de Chantal Rd
Wheeling, WV 26003-6334
Phone
(304) 242-1273
Fax
(304) 242-1422
NPI assigned
Sep 26, 2006
Last updated
Nov 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Dr. Robert J Fanning Jr., DONPI 1962408369
Title
Cardiologist
Phone
(304) 242-1273

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 46155 WV
Specialist 174400000X 1431 WV Primary

Addresses

Primary practice location

1307 Mount de Chantal Rd
Wheeling, WV 26003-6334

Mailing address

1307 Mount de Chantal Rd
Wheeling, WV 26003-6334
Phone (304) 242-1273

Other identifiers 1

IdentifierTypeStateIssuer
6001141MedicaidWV

National Provider Directory

National Provider Directory

Locations

1307 Mount de Chantal Rd
Wheeling, WV 26003
Phone (304) 242-1273

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1933/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1376644625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 MOUNT DE CHANTAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036334",
            "telephone_number": "304-242-1273",
            "fax_number": "304-242-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 MOUNT DE CHANTAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036334",
            "telephone_number": "304-242-1273",
            "fax_number": "304-242-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J FANNING, JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "FANNING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CARDIOLOGIST",
        "authorized_official_telephone_number": "304-242-1273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "46155",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "1431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001141",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.