{
"Npi": {
"NPI": "1598147431",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOUTHERN WEST VIRGINIA PRIMARY CARE INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "415 CARRIAGE DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BECKLEY",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25801",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-250-0142",
"MailingAddressFaxNumber": "304-253-7262",
"FirstLinePracticeLocationAddress": "415 CARRIAGE DRIVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BECKLEY",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "25801",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-250-0142",
"PracticeLocationAddressFaxNumber": "304-253-7262",
"EnumerationDate": "06/28/2015",
"LastUpdateDate": "01/12/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MORRELLO",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "WAYNE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "304-250-0142",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "23171147",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}