JUDY JONES PETERSEN D.O. NPI 1023251840

NPI Information

NPI: 1023251840
Provider Name: JUDY JONES PETERSEN, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
600 MORRIS ST
SUITE 103
CHARLESTON, WV
ZIP 25301
Phone: (304) 388-7040
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Judy Jones Petersen, D.O. is a family medicine in Charleston, WV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Judy Jones Petersen, D.O. NPI is 1023251840. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

600 MORRIS ST
SUITE 103
CHARLESTON, WV
ZIP 25301-409
Phone: (304) 388-7040
Fax: (304) 388-7041

The enumeration date for this NPI number is 4/8/2009 and was last updated on 9/6/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	207Q00000X	Family Medicine		1108	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P0106337	OTHER	WEST VIRGINIA	MEDICARE RAILROAD
2	0041503000	MEDICAID	WEST VIRGINIA
3	WV0345A	MEDICARE PIN	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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