Shenandoah Preventive Medicine, Inc.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

1000 Issued in WV

Legal business name

SHENANDOAH PREVENTIVE MEDICINE, INC.

Practice address

215 S Louisiana Ave
Martinsburg, WV 25401-2037

Phone

(304) 263-3335

Fax

(304) 267-5557

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Alexander Burgess V, D.O.

Title

President

Phone

(304) 263-3335

Specialties & licenses 1

Addresses

Other names 1

• J.A. Burgess V, D.O. Other name

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518089366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S LOUISIANA AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012037",
            "telephone_number": "304-263-3335",
            "fax_number": "304-267-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S LOUISIANA AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012037",
            "telephone_number": "304-263-3335",
            "fax_number": "304-267-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH PREVENTIVE MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-263-3335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "V",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "WV",
            "license": "1000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J.A. Burgess V, D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Betty Shelton
• Cameron Shelton
• Kelly Shelton
• Shenandoah Laboratories, LLC
• Shenandoah Pharmacy, LLC
• Shenandoah Valley Medical System, Inc.
• Shenandoah Valley Medical System, Inc.
• Shenandoah Valley Medical System, Inc.
• Shenandoah Valley Medical System, Inc.
• Shenandoah Valley Medical System, Inc.

• Neuromusculoskeletal Medicine & OMM Physician in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Neuromusculoskeletal Medicine & OMM 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.