Jana Peters

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

WV381 Issued in WV

Legal business name

JANA PETERS

Practice address

365 Courthouse Road
Princeton, WV 24740

Phone

(304) 425-3922

Fax

(304) 487-0229

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Jana M Peters, DO

Title

Owner

Phone

(304) 425-3922

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Rural health clinic certification: CCN 513891

Legal name

JANA PETERS

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Nov 18, 1997

Last certification

Apr 22, 2024

Ownership / control type

1A

Organization structure

OtherProprietary

Enrollment address

365 Courthouse Road
Princeton, WV 24740-2431

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Huntington Center for Pain Treatment LLP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Huntington Center for Pain Treatment, LLP

  • Pain Medicine (Anesthesiology) Physician
  • Huntington, NY
  • NPI 1346495900
  NPD tax ID

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jana Michelle Peters, DO

  • Family Medicine Physician
  • Princeton, WV
  • NPI 1952444234

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 3

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

• Christie Ann Hill-Hurt, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Princeton, WV
  • NPI 1871747899
  NPD (past)
• Mary Ann Lester, PAC

  • Physician Assistant
  • Princeton, WV
  • NPI 1750713269
  NPD (past)
• Ryan T Runyon, DO

  • Family Medicine Physician
  • Princeton, WV
  • NPI 1932115938
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1396875746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 COURTHOUSE ROAD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-425-3922",
            "fax_number": "304-487-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 COURTHOUSE ROAD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-425-3922",
            "fax_number": "304-487-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANA PETERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-425-3922",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "WV381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT STATE BCBS",
            "identifier": "001720758",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041701001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Jackson
• Kegan Elizabeth Jackson, MSW, LGSW
• Pricilla Jackson
• Rafael Douglas Jackson
• Tisha James, RD, LD
• Andrew Janes, PRSS
• Kristy Janutolo, RN
• Courtney Jefferson, FNP-C
• Jeffrey Greenberg MD PLLC
• Amanda Jenkins

• Family Medicine Physician in Princeton, WV
• Providers in Princeton, 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 Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.