NPIMap

Organization Active NPI

Eden Family Practice Inc.

  • Family Medicine Physician
  • Logan, WV
National Provider Identifier
1821049776
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1939 Issued in WV
Legal business name
EDEN FAMILY PRACTICE INC.
Practice address
313 Hudgins St
Suite 200
Logan, WV 25601-3535
Phone
(304) 752-9450
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Patty Radcliffe
Title
Cfo
Phone
(614) 876-9233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1939 WV Primary

Addresses

Primary practice location

313 Hudgins St
Suite 200
Logan, WV 25601-3535

Mailing address

3306 Bridget Dr
Columbus, OH 43221-4431
Phone (614) 876-9233

National Provider Directory

National Provider Directory

Locations

313 Hudgins St
Ste 200
Logan, WV 25601
Phone (304) 752-9450

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821049776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 BRIDGET DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432214431",
            "telephone_number": "614-876-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 HUDGINS ST",
            "address_2": "SUITE 200",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013535",
            "telephone_number": "304-752-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN FAMILY PRACTICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RADCLIFFE",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-876-9233",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • 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.