NPIMap

Organization Active NPI

Grant Memorial Hospital

Doing business as Grant Memorial Hospital Family Medicine Clinic

  • Family Medicine Physician
  • Petersburg, WV
National Provider Identifier
1669885158
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21 Issued in WV
Legal business name
GRANT MEMORIAL HOSPITAL
Doing business as
Grant Memorial Hospital Family Medicine Clinic
Practice address
65 Hospital Dr
Suite 106
Petersburg, WV 26847-9549
Phone
(304) 257-4511
Fax
(304) 257-4511
NPI assigned
Jun 3, 2014
Last updated
Mar 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Authorized official

Name
Mr. Robert W Milvet Jr.
Title
Ceo
Phone
(305) 257-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21 WV Primary

Addresses

Primary practice location

65 Hospital Dr
Suite 106
Petersburg, WV 26847-9549

Mailing address

PO Box 1019
Petersburg, WV 26847-1019
Phone (304) 257-4511

Other names 1

  • Grant Memorial Hospital Family Medicine Clinic Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1669885158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1019",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471019",
            "telephone_number": "304-257-4511",
            "fax_number": "304-257-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HOSPITAL DR",
            "address_2": "SUITE 106",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268479549",
            "telephone_number": "304-257-4511",
            "fax_number": "304-257-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "MILVET",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-257-5800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Memorial Hospital Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grant Memorial Hospital Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.