ADAM M PENFOLD


Address: 2373 W Main St, Ste 102, Salem, WV 26426-7515
Phone: 3047822000

ADAM M PENFOLD (NPI# 1023423613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023423613
Entity Type Individual
Full Name ADAM M PENFOLD
Credential PA-C
Practice Address 2373 W Main St
Ste 102
Salem
WV 26426-7515
Mailing Address Po Box 392
Salem
WV 26426-0392
Practice Telephone 3047822000
Practice Fax Number 3047823102
Mailing Telephone 3047822000
Mailing Fax Number 3047823102
Enumeration Date 2014-06-23
Last Update Date 2014-06-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
2610 WV Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WV TEMPORARY STATE LICENSE 2610 01

Office Location

Street Address 2373 W MAIN ST
STE 102
City SALEM
State WV
Zip Code 26426-7515

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083725287 Jimmie D Hissem Dentist 2373 W Main St, Salem, WV 26426-7515 2006-08-31
1982054698 Nancy Allen Nurse Practitioner 2373 W Main St, Ste 102, Salem, WV 26426-7515 2016-06-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063972099 Phillip King Occupational Therapist 225 Sunbridge Dr., Salem, WV 26426 2019-03-25
1609367077 Jennifer Turner Nurse Practitioner 225 Sunbridge Drive, Salem, WV 26426 2018-05-22
1295240992 Charlotte Spicer Technician 57 New York Avenue, Salem, WV 26426 2017-12-05
1649639618 City of Salem Ambulance 60 Mills Street, Salem, WV 26426 2016-02-18
1114351202 Alexandria Danielle Johnson Nurse Practitioner 2373 W. Main St., Suite 102, Salem, WV 26426 2013-08-26
1427173913 Tracy Lynn Brady Physical Therapy Assistant 146 Water St., Salem Care and Rehabilitation, Salem, WV 26426 2007-03-21
1144329707 Mary Caroline Mikowski Family Medicine Rt 50 West, Salem, WV 26426 2006-09-21
1174521850 Michelle Renee Wickline Optometrist Rt 1 Box 75-4, Salem, WV 26426 2005-07-07
1619329331 Melissa Braun Student in an Organized Health Care Education/Training Program 225 Water St, Salem, WV 26426 2016-07-06
1861685281 Joseph Audia, Od Optometrist Rt 1 Box 75-4, Salem, WV 26426 2007-08-20
Find all providers in zip 26426

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285255851 Darby Samantha Jalbert Physician Assistant 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 2020-05-05
1639614852 Gregory Bull Physician Assistant 622 Fernwood Dr, Salem, VA 24153-2654 2016-12-24
1841648862 Theron J Wiese Physician Assistant 1395 Commercial St Se, Salem, OR 97302-4205 2016-05-31
1922329697 Charleen Ann Thorburn Physician Assistant 22 Keewaydin Dr, Salem, NH 03079-2839 2010-06-17
1316188006 Judith A Mitchell Physician Assistant 4999 Skyline Rd. S., Salem, OR 97306 2009-03-10
1215912712 Amy Gouley Physician Assistant 1793 13th St Se, Salem, OR 97302-2541 2005-12-07
1306827100 William Earle Williams Physician Assistant 1233 Edgewater St Nw, Salem, OR 97304-4049 2005-11-08
1700485224 Roderick Mao Physician Assistant 159 N Broadway, Salem, NH 03079-2136 2020-10-26
1447719752 Christine Nicole Jeffries Physician Assistant 360 Church St Se, Salem, OR 97301-3796 2019-03-16
1265999338 Brolin Johnson Physician Assistant 1793 13th St Se, Salem, OR 97302-2541 2019-02-26
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Competitor

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City SALEM
Zip Code 26426

Improve Information

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Dataset Information

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.

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