Organization Active NPI

West Jefferson Family Practice Inc

  • Family Medicine Physician
  • West Jefferson, OH
National Provider Identifier
1508991001
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEST JEFFERSON FAMILY PRACTICE INC
Practice address
2 E Main St
West Jefferson, OH 43162-1202
Phone
(614) 879-6770
Fax
(614) 879-7067
NPI assigned
Feb 23, 2007
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Dr. Mark W Garwood, DONPI 1275595274
Title
Owner Physican
Phone
(614) 879-6770

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 Physician 207Q00000X Primary

Addresses

Primary practice location

2 E Main St
West Jefferson, OH 43162-1202

Mailing address

2 E Main St
West Jefferson, OH 43162-1202
Phone (614) 879-6770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051219000265 OH Part B Supplier - Clinic/Group Practice 5698796654 Receives reassigned benefits from 1 practitioner
Practice locations: West Jefferson, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1508991001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E MAIN ST",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431621202",
            "telephone_number": "614-879-6770",
            "fax_number": "614-879-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E MAIN ST",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431621202",
            "telephone_number": "614-879-6770",
            "fax_number": "614-879-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "GARWOOD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER PHYSICAN",
        "authorized_official_telephone_number": "614-879-6770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jefferson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.