Peter M Barnovsky DO Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34-00-5712 Issued in OH

Legal business name

PETER M BARNOVSKY DO INC

Practice address

500 Wakefield Dr
Cortland, OH 44410-1504

Phone

(330) 638-4010

Fax

(330) 638-1540

NPI assigned

Aug 3, 2005

Last updated

Jun 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Traci Sue Wolford

Title

Office Manager

Phone

(330) 638-4010

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1639170426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WAKEFIELD DR",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444101504",
            "telephone_number": "330-638-4010",
            "fax_number": "330-638-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WAKEFIELD DR",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444101504",
            "telephone_number": "330-638-4010",
            "fax_number": "330-638-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER M BARNOVSKY DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WOLFORD",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-638-4010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-00-5712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157735",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Cortland, OH
• Providers in Cortland, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.