GARY J PETTY (NPI# 1942279013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942279013 |
| Entity Type | Individual |
| Full Name | GARY J PETTY |
| Credential | M.D. |
| Practice Address |
659 Central Ave Barboursville WV 25504 |
| Mailing Address |
659 Central Ave Barboursville WV 25504-1313 |
| Practice Telephone | 3047365247 |
| Practice Fax Number | 3047367367 |
| Mailing Telephone | 3047365247 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-07-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 17521 | WV | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036118847 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 50755020 | WI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 35-07-5727 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM | 000000593893 | 01 |
| OH | ANTHEM | 000000699790 | 01 |
| OH | 1804764000 | 05 | |
| OH | 2255250 | 05 | |
| OH | RRMCR | P00693880 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 210 N 7th St, Suite 100, Marietta, OH 457502244 | 7403742999 | 7403743121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356366504 | Gary Leon Petty | Psychologist | 1118 Barkdull St, Houston, TX 77006-6402 | 2006-07-12 |
| Street Address |
659 CENTRAL AVE |
| City | BARBOURSVILLE |
| State | WV |
| Zip Code | 25504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990049 | Cynthia A Winger | Family Medicine | 659 Central Ave, Barboursville, WV 25504-1313 | 2006-04-11 |
| 1538129010 | Tammy L Bannister | Family Medicine | 659 Central Ave, Barboursville, WV 25504-1313 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143115 | Jeff Thomas Slone | Technician | 3350 Holland Creek Road, Barboursville, WV 25504 | 2020-10-30 |
| 1134679061 | Ryan Young | Pharmacist | 6350 Us Route 60 East, Barboursville, WV 25504 | 2016-10-04 |
| 1447706361 | Jennifer M Bruce | Nurse Anesthetist, Certified Registered | 5840 Davis Creek Rd. Suite E, Barboursville, WV 25504 | 2016-08-31 |
| 1528447794 | Susan Berry | Licensed Practical Nurse | 1 Ohanlon Place, Barboursville, WV 25504 | 2015-05-21 |
| 1902209067 | Eric W Kutcher | Nurse Anesthetist, Certified Registered | 5840 Davis Creek Road Suite E, Barboursville, WV 25504 | 2014-10-03 |
| 1275940843 | Alex G Smith | Nurse Anesthetist, Certified Registered | 5840 Davis Creek Road, Suite E, Barboursville, WV 25504 | 2014-07-16 |
| 1225451297 | Carol Newlon | Counselor | 689 Central Avenue, Barboursville, WV 25504 | 2014-01-28 |
| 1598003386 | Amy E Crabtree | Pharmacist | 6414 Us 60 East, Barboursville, WV 25504 | 2013-01-29 |
| 1538428669 | Amy Beth Cope | Physician Assistant | 6171 Childers Road, Barboursville, WV 25504 | 2012-05-09 |
| 1508167867 | Tara J. Robinson | Dermatology | 6007 U.S.rt 60 E., Suite 130, Barboursville, WV 25504 | 2010-11-03 |
| Find all providers in zip 25504 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740351436 | Francisco Arcigual Constantino | Family Medicine | 15960 Us Route 60 East, Barboursville, WV 25504 | 2006-11-13 |
| 1265400840 | David Reid Steele | Family Medicine | 1 Chateau Lane, Barboursville, WV 25504-1627 | 2006-03-09 |
| 1104804814 | Mary L Marcuzzi | Family Medicine | 100 Meadow Pointe, Family Medical Center, Barboursville, WV 25504 | 2006-01-03 |
| 1194724534 | Kathy L Saber | Family Medicine | 6475 Farmdale Rd, Barboursville, WV 25504-1321 | 2005-07-19 |
| 1508311390 | Valley Health Systems, Inc | Family Medicine | 6350 Us Route 60 E, Barboursville, WV 25504-1232 | 2016-08-22 |
| 1538456892 | Clifton Bolinger | Family Medicine | 143 Peyton St, Barboursville, WV 25504-2063 | 2011-07-06 |
| 1801125752 | Main Street Medical Pllc | Family Medicine | 650 Main St, Barboursville, WV 25504-1439 | 2009-12-23 |
| 1992899678 | Area Health Systems Incorporated | Family Medicine | 6007 Us Route 60 E, Barboursville, WV 25504 | 2006-10-03 |
| 1093814717 | Gregory Chaney | Family Medicine | 6007 Us Route 60 E, Barboursville, WV 25504 | 2006-09-21 |
| 1396781670 | Benjamin Allan | Family Medicine | 143 Peyton Street, Barboursville, WV 25504 | 2006-06-22 |
| Find all providers in BARBOURSVILLE | ||||
| City | BARBOURSVILLE |
| Zip Code | 25504 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.