Bruceton Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BRUCETON MEDICAL CENTER

Practice address

198 Morgantown Street
Suite B
Bruceton Mills, WV 26525

Phone

(304) 379-7600

Fax

(304) 379-7599

NPI assigned

Mar 2, 2012

Last updated

Jul 31, 2013By 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

Dr. Robert Phares, MD

Title

Owner

Phone

(304) 379-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1811261225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "265251150",
            "telephone_number": "304-379-7600",
            "fax_number": "304-379-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MORGANTOWN STREET",
            "address_2": "SUITE B",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "26525",
            "telephone_number": "304-379-7600",
            "fax_number": "304-379-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCETON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "PHARES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-379-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005711000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of West Virginia, Inc. (Fresenius Medical Care of Bruceton Mills)
• Regin Brobeck
• Kristine Brown, PHD
• Bruceton Dental PLLC
• Bruceton Family Medicine LLC
• Bruceton Mill Community Ambulance, Inc.
• Bruceton Mills Family Dentistry
• Bruceton Pharmacy
• Bruceton Wellness Center PLLC
• Savannah Bryner

• Primary Care Clinic/Center in Bruceton Mills, WV
• Providers in Bruceton Mills, WV by specialty
• Primary Care Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.