NPIMap

Organization Active NPI

Mount Vernon Family Practice Inc

  • Family Medicine Physician
  • Mount Vernon, OH
National Provider Identifier
1528053352
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35069571 Issued in OH
Legal business name
MOUNT VERNON FAMILY PRACTICE INC
Practice address
10 Woodlake TRL
Suite B
Mount Vernon, OH 43050-9573
Phone
(740) 397-2244
Fax
(740) 397-2993
NPI assigned
Sep 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Dr. Amy Denise Murnen, M.D.NPI 1750376687
Title
President
Phone
(740) 397-2244

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 35069571 OH Primary

Addresses

Primary practice location

10 Woodlake TRL
Suite B
Mount Vernon, OH 43050-9573

Mailing address

10 Woodlake TRL
Suite B
Mount Vernon, OH 43050-9573
Phone (740) 397-2244

Other identifiers 2

IdentifierTypeStateIssuer
35069571OtherOHSTATE MEDICAL LICENSE
2499970MedicaidOH

National Provider Directory

National Provider Directory

Locations

1451 Yauger Rd
Ste 1E
Mount Vernon, OH 43050
Phone (740) 397-2244

10 Woodlake Trl
Ste B
Mount Vernon, OH 43050
Phone (740) 397-2244

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": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1528053352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODLAKE TRL",
            "address_2": "SUITE B",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509573",
            "telephone_number": "740-397-2244",
            "fax_number": "740-397-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAKE TRL",
            "address_2": "SUITE B",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509573",
            "telephone_number": "740-397-2244",
            "fax_number": "740-397-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "MURNEN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-397-2244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35069571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "35069571",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2499970",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.