Five Oaks Family Clinic, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

14161 Issued in WV

Legal business name

FIVE OAKS FAMILY CLINIC, INC.

Practice address

RR 3 Box 458E
Fayetteville, WV 25840-9589

Phone

(304) 574-1888

Fax

(304) 574-1891

NPI assigned

May 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Douglas White, MD

Title

President

Phone

(304) 574-1890

Specialties & licenses 1

Addresses

Practitioners 1

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

• Carrie Murrell, PA-C

  • Physician Assistant
  • Fayetteville, WV
  • NPI 1588697130
  NPD

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

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841247368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 458E",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258409589",
            "telephone_number": "304-574-1888",
            "fax_number": "304-574-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 458E",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258409589",
            "telephone_number": "304-574-1888",
            "fax_number": "304-574-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE OAKS FAMILY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-574-1890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "14161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Fayetteville, WV
• Providers in Fayetteville, 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 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.