Ravenswood Family Medicine Ctr

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19979 Issued in WV

Legal business name

RAVENSWOOD FAMILY MEDICINE CTR

Practice address

316 Washington St
Ravenswood, WV 26164-1704

Phone

(304) 273-2647

Fax

(304) 273-2636

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Arif M MalikNPI 1679534630

Title

Owner

Phone

(304) 903-4579

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Arif M Malik, MD

  • Internal Medicine Physician
  • Ravenswood, WV
  • NPI 1679534630
  Medicare reassignment NPD Authorized official
• Barbara L Stagg, CFNP

  • Nurse Practitioner
  • Harrisville, WV
  • NPI 1467421719
  NPD (past)
• Shawnna D. Walker, FNP-BC

  • Family Nurse Practitioner
  • Charleston, WV
  • NPI 1033397401
  NPD (past)
• Shark Bird, MD

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1346355849
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1770689481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261640325",
            "telephone_number": "304-273-4479",
            "fax_number": "304-273-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641704",
            "telephone_number": "304-273-2647",
            "fax_number": "304-273-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSWOOD FAMILY MEDICINE CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "ARIF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-903-4579"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "19979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy Providers PLLC
• Marissa Kay Poorman, PHARMD
• Renea Pursley
• Quad/Med, LLC
• Kimberly Renee Rankin
• Ravenswood Pharmacy LLC (Ravenswood Drug)
• Ravenswood Village Opco, LLC
• Rex Allen Cummings Inc
• Corrie Lyn Runnion
• Michael Paul Rush

• Internal Medicine Physician in Ravenswood, WV
• Providers in Ravenswood, WV by specialty
• Internal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.