NPIMap

Organization Active NPI

WV Family Medicine,Inc

  • Primary Care Clinic/Center
  • West Logan, WV
National Provider Identifier
1528284247
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
22060 Issued in WV
Legal business name
WV FAMILY MEDICINE,INC
Practice address
1115 2ND Ave
West Logan, WV 25601-3309
Phone
(304) 831-0085
Fax
(304) 831-0088
NPI assigned
Apr 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Karunasree Kanuri, M.D.NPI 1174612907
Title
President
Phone
(304) 831-0085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Primary Care Clinic/Center 261QP2300X 22060 WV Primary

Addresses

Primary practice location

1115 2ND Ave
West Logan, WV 25601-3309

Mailing address

1115 2ND Ave
West Logan, WV 25601-3309
Phone (304) 831-0085

Other identifiers 1

IdentifierTypeStateIssuer
3810003597MedicaidWV

National Provider Directory

National Provider Directory

Locations

1115 2nd Ave
West Logan, WV 25601
Phone (304) 831-0085

1115 2nd Ave
#10
West Logan, WV 25601
Phone (304) 831-0085

Practitioners & affiliated clinicians

Practitioners 2

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": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528284247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 2ND AVE",
            "city": "WEST LOGAN",
            "state": "WV",
            "postal_code": "256013309",
            "telephone_number": "304-831-0085",
            "fax_number": "304-831-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 2ND AVE",
            "city": "WEST LOGAN",
            "state": "WV",
            "postal_code": "256013309",
            "telephone_number": "304-831-0085",
            "fax_number": "304-831-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV FAMILY MEDICINE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANURI",
        "authorized_official_first_name": "KARUNASREE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-831-0085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "22060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003597",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Logan, WV

Sources for this page

  • 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.