NPIMap

Organization Active NPI

Peterstown Wellness Center

Doing business as Monroe Health Center

  • Family Medicine Physician
  • Union, WV
National Provider Identifier
1962696682
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PETERSTOWN WELLNESS CENTER
Doing business as
Monroe Health Center
Practice address
200 Health Center Dr
Union, WV 24983
Phone
(304) 772-3064
Fax
(304) 772-3296
NPI assigned
Sep 6, 2007
Last updated
Sep 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Authorized official

Name
Roger Brady
Title
Ceo
Phone
(304) 772-3064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

200 Health Center Dr
Union, WV 24983

Mailing address

108 College Dr
Peterstown, WV 24963
Phone (304) 753-6960

Other names 1

  • Monroe Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Monroe County Health Center Board of Trustees11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1962696682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 COLLEGE DR",
            "city": "PETERSTOWN",
            "state": "WV",
            "postal_code": "24963",
            "telephone_number": "304-753-6960",
            "fax_number": "304-753-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH CENTER DR",
            "city": "UNION",
            "state": "WV",
            "postal_code": "24983",
            "telephone_number": "304-772-3064",
            "fax_number": "304-772-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSTOWN WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-772-3064"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.