NPIMap

Organization Active NPI

Family Health Center PLLC

  • Primary Care Clinic/Center
  • Martinsburg, WV
National Provider Identifier
1912250663
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
22758 Issued in WV
Legal business name
FAMILY HEALTH CENTER PLLC
Practice address
1004 Sushruta Dr Ste C
Martinsburg, WV 25401-8801
Phone
(304) 264-0888
Fax
(304) 264-0878
NPI assigned
Oct 18, 2012
Last updated
Feb 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Mehran KhajaviNPI 1013136464
Title
Owner/Physician
Phone
(304) 264-0888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 22758 WV Primary

Addresses

Primary practice location

1004 Sushruta Dr Ste C
Martinsburg, WV 25401-8801

Mailing address

P.O. Box 4458
Leesburg, VA 20177
Phone (703) 895-2237

Other identifiers 2

IdentifierTypeStateIssuer
3810026141MedicaidWV
C487OtherWVMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

1004 Sushruta Dr
Ste C
Martinsburg, WV 25401
Phone (304) 264-0888

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1912250663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4458",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20177",
            "telephone_number": "703-895-2237",
            "fax_number": "304-264-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 SUSHRUTA DR STE C",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018801",
            "telephone_number": "304-264-0888",
            "fax_number": "304-264-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "KHAJAVI",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "304-264-0888"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "22758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026141",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C487",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.