Chua Family Practice, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

WV1965 Issued in WV

Legal business name

CHUA FAMILY PRACTICE, PLLC

Practice address

1092 Harrison Ave
Elkins, WV 26241-3671

Phone

(304) 637-0433

Fax

(304) 637-0435

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Connie M Brown, RN

Title

Office Manager

Phone

(304) 637-0433

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Allyson Malone Andrews, PA-C

  • Medical Physician Assistant
  • Buckhannon, WV
  • NPI 1164405569
  NPD (past)
• Catherine M. Chua, D.O.

  • Family Medicine Physician
  • Elkins, WV
  • NPI 1295726685

  Family Medicine

  NPD (past)
• Domingo T Chua, MD

  • Urology Physician
  • Elkins, WV
  • NPI 1871591818
  NPD (past)
• Philip J. Chua, D.O.

  • Family Medicine Physician
  • Elkins, WV
  • NPI 1467433649

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700948239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262410490",
            "telephone_number": "304-637-0433",
            "fax_number": "304-637-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 HARRISON AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413671",
            "telephone_number": "304-637-0433",
            "fax_number": "304-637-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUA FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-637-0433",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "WV1833",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "WV1965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004769",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00012945",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00118111",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joslyn Faith Childers
• Mackenzie Childers
• Zatoya Childs
• Anne Marie Chopyak, NCC
• Christopher Yearego, OD and Associates, PLLC
• Catherine M. Chua, D.O.
• Domingo T Chua, MD
• Philip J. Chua, D.O.
• Clark Physical Therapy Services, LLC
• Darlene Kim Clark, P.T.

• All providers in Elkins, WV
• Family Medicine Physician in West Virginia

• 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.