{
"Npi": {
"NPI": "1285975383",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "URGENT CARE, INC. - WEST VIRGINIA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "423 FORTRESS BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MORGANTOWN",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "26508-1351",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-225-2500",
"MailingAddressFaxNumber": "304-985-6350",
"FirstLinePracticeLocationAddress": "277 GREASY RIDGE ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PRINCETON",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "24740",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-425-7615",
"PracticeLocationAddressFaxNumber": "304-425-7635",
"EnumerationDate": "03/14/2013",
"LastUpdateDate": "05/02/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GALLAGHER",
"AuthorizedOfficialFirstName": "JASON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF CONTRACTING",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "304-225-2500",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "60610",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}