Braddock Medical Group P.A.
NPI 1104962729 · Adult Medicine Physician · Fort Ashby, WV
Braddock Medical Group P.A. is a Adult Medicine Physician organization in Fort Ashby, WV (NPI 1104962729).
Provider details
- NPI number
- 1104962729
- Entity type
- Organization
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Braddock Medical Group PA
- Organization subpart
- Yes
- Authorized official
- Paul Livengood, Owner(304) 298-3605
- License
- 11172 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Fort Ashby Family Practice
Registry dates
- Enumerated
- 2007-01-30
- Last updated
- 2016-11-01
Frequently asked questions
- What is Braddock Medical Group P.A.'s NPI number?
- Braddock Medical Group P.A.'s National Provider Identifier (NPI) is 1104962729, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Braddock Medical Group P.A.?
- Braddock Medical Group P.A. is classified in the NPPES registry as Adult Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Braddock Medical Group P.A. located?
- Braddock Medical Group P.A.'s practice location on file with NPPES is 70 Presidents Street, Fort Ashby, WV 26719-1150.
- What is Braddock Medical Group P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Braddock Medical Group P.A. is (304) 298-3605.
- Who is the authorized official for Braddock Medical Group P.A.?
- The authorized official listed on Braddock Medical Group P.A.'s NPPES record is Paul Livengood, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Braddock Medical Group P.A.'s NPI active?
- Yes — Braddock Medical Group P.A.'s NPI (1104962729) is active in the NPPES registry as of the last update on 2016-11-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.