NPIMap

Organization Active NPI

Princeton Family Health Care PLLC

  • Family Medicine Physician
  • Princeton, WV
National Provider Identifier
1487785960
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1715 Issued in WV
Legal business name
PRINCETON FAMILY HEALTH CARE PLLC
Practice address
401 12TH Street Ext
Princeton, WV 24740-2300
Phone
(304) 431-5041
Fax
(304) 425-6121
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Dr. Telitha Donet Glasscock, D.O.NPI 1144215666
Title
Owner
Phone
(304) 431-5041

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: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 1715 WV Primary

Addresses

Primary practice location

401 12TH Street Ext
Princeton, WV 24740-2300

Mailing address

401 12TH Street Ext
Princeton, WV 24740-2300
Phone (304) 431-5041

Other names 1

  • T. Donet Glasscock, D.O. Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1487785960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402300",
            "telephone_number": "304-431-5041",
            "fax_number": "304-425-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402300",
            "telephone_number": "304-431-5041",
            "fax_number": "304-425-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON FAMILY HEALTH CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "GLASSCOCK",
        "authorized_official_first_name": "TELITHA",
        "authorized_official_middle_name": "DONET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-431-5041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T. Donet Glasscock, D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.