Active NPI
Family Recovery, LLC
- Addiction Medicine (Family Medicine) Physician
- Williamsport, PA
National Provider Identifier
1588905723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- MD042726L
- Legal business name
- FAMILY RECOVERY, LLC
- Practice address
- 1101 E 3Rd St
Williamsport, PA 17701-5411 - Phone
- (570) 505-3180
- Fax
- (570) 505-3184
- NPI assigned
- Mar 13, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bruce Jarvie
- Title
- VP, Treasurer
- Phone
- (214) 379-3300
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Anesthesiology) Physician | 207LA0401X | MD042726L | PA | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | MD042726L | PA | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | MD443569 | PA | |
| Family Medicine Physician | 207Q00000X | MD042726L | ||
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | MD042726L | PA | Primary |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | OS014721 | PA | |
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | MD018954E | PA | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | MD045007L | PA | |
| Obstetrics & Gynecology Physician | 207V00000X | MD036563L | PA | |
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | MD443569 | PA | |
| Addiction Psychiatry Physician | 2084P0802X | MD039704E | PA | |
| Hospitalist Physician | 208M00000X | MD433062 | PA | |
| Pain Medicine Physician | 208VP0000X | MD042726L | PA | |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
1101 E 3Rd St
Williamsport, PA 17701-5411
Mailing address
1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300
Other names 1
- AppleGate Recovery Williamsport
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2090129 | Family Recovery, LLC | Certificate of waiver | Jan 14, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722211200000",
"number": "1588905723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 LAKEPOINTE DR STE 117",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750576425",
"telephone_number": "214-379-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E 3RD ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177015411",
"telephone_number": "570-505-3180",
"fax_number": "570-505-3184"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY RECOVERY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-13",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A",
"authorized_official_last_name": "JARVIE",
"authorized_official_first_name": "BRUCE",
"authorized_official_title_or_position": "VP, TREASURER",
"authorized_official_telephone_number": "214-379-3300"
},
"taxonomies": [
{
"code": "207LA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Addiction Medicine",
"state": "PA",
"license": "MD042726L",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": "PA",
"license": "MD042726L",
"primary": false
},
{
"code": "207PE0004X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "PA",
"license": "MD443569",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": "MD042726L",
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": "PA",
"license": "MD042726L",
"primary": true
},
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": "PA",
"license": "OS014721",
"primary": false
},
{
"code": "207RA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Addiction Medicine",
"state": "PA",
"license": "MD018954E",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "PA",
"license": "MD045007L",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD036563L",
"primary": false
},
{
"code": "2084A0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "PA",
"license": "MD443569",
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "PA",
"license": "MD039704E",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": "PA",
"license": "MD433062",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": "PA",
"license": "MD042726L",
"primary": false
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "AppleGate Recovery Williamsport",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.