COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1063048189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063048189 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Practice Address |
34 N Kanawha St Buckhannon WV 26201-2714 |
| Practice Telephone | 3049246262 |
| Practice Fax Number | 3049246699 |
| Mailing Telephone | 3049246262 |
| Mailing Fax Number | 3049246699 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 3045615319 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | WEST VIRGINIA BUSINESS LICENSE | 2386-2367 | 01 |
| Other Name | Type Code |
|---|---|
| Community Care Connections of Buckhannon | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1538711452 | Community Care of West Virginia, Inc. | Clinic/Center | 481 Heavner Grove Rd, Buckhannon, WV 26201-4859 | 2019-07-11 |
| 1710539630 | Community Care of West Virginia, Inc. | Clinic/Center | 5078 Tallmansville Rd, Buckhannon, WV 26201-1687 | 2019-07-11 |
| 1871003178 | Community Care of West Virginia, Inc. | Clinic/Center | 228 Kanawha Avenue, Burnsville, WV 26335 | 2017-10-02 |
| 1053821363 | Community Care of West Virginia, Inc. | Clinic/Center | 55 Little Birch Rd, Sutton, WV 26601-9469 | 2017-10-02 |
| 1609386978 | Community Care of West Virginia, Inc. | Clinic/Center | 15300 Us Highway 33 W, Linn, WV 26384-9322 | 2017-10-02 |
| 1962912261 | Community Care of West Virginia, Inc. | Clinic/Center | 142 Flatwoods Corner Road, Flatwoods, WV 26621 | 2017-10-02 |
| 1811366248 | Community Care of West Virginia, Inc. | Clinic/Center | 501 Bomont Rd, Bomont, WV 25030-9666 | 2015-09-16 |
| 1043686553 | Community Care of West Virginia, Inc. | Clinic/Center | 358 Court Ave, Weston, WV 26452-2008 | 2015-08-19 |
| 1194191676 | Community Care of West Virginia, Inc. | Clinic/Center | 1 Lizemore Street, Lizemores, WV 25125 | 2015-08-19 |
| Street Address |
34 N KANAWHA ST |
| City | BUCKHANNON |
| State | WV |
| Zip Code | 26201-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417570334 | Susan Boyce | Homemaker | 62692 Tallmasville Road, Buckhannon, WV 26201 | 2020-05-27 |
| 1316590177 | Jk Marketing, LLC | Clinic/Center | 4 Hartman Plaza, Buckhannon, WV 26201 | 2019-07-22 |
| 1841759412 | Deborah Lynn Wilson | Massage Therapist | 47 East Main St., Suite 202, Buckhann, WV 26201 | 2019-03-13 |
| 1275041766 | Town of Anmoore Vol Fire Dept | Ambulance | 100 S Ash Street, Anmoore, WV 26201 | 2018-01-18 |
| 1265824411 | Erik Brown | Specialist/Technologist | 36 College Avenue, Buckhannon, WV 26201 | 2015-02-25 |
| 1053735118 | Jonas Layne Phares | Chiropractor | Rt 20 Professional Arts Plaza Dr, Buckhannon, WV 26201 | 2014-02-10 |
| 1750621132 | Drew Foster Mason | Specialist/Technologist | 54 College Avenue, Box 1746, Buckhannon, WV 26201 | 2013-02-22 |
| 1295070241 | Cynthia Jean Hurst | Physician Assistant | 50 Bu Drive, Buckhannon, WV 26201 | 2012-12-03 |
| 1679876197 | Holly Evans | Pharmacist | Route 20 South, Buckhannon, WV 26201 | 2010-12-07 |
| 1407069990 | Upshur-buckhannon Health Department | Public Health or Welfare | 15 North Locust Street, Buckhannon, WV 26201 | 2007-05-08 |
| Find all providers in zip 26201 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1538711452 | Community Care of West Virginia, Inc. | Clinic/Center | 481 Heavner Grove Rd, Buckhannon, WV 26201-4859 | 2019-07-11 |
| 1710539630 | Community Care of West Virginia, Inc. | Clinic/Center | 5078 Tallmansville Rd, Buckhannon, WV 26201-1687 | 2019-07-11 |
| 1891241030 | Community Care of West Virginia,inc. | Clinic/Center | 33-37 W Main Street, Buckhannon, WV 26201-2235 | 2016-08-28 |
| 1992144273 | Community Care of West Virginia, Inc. | Clinic/Center | Rr 6 Box 303, Buckhannon, WV 26201-8830 | 2013-06-19 |
| 1104177674 | Community Care of West Virginia, Inc. | Clinic/Center | 50 Bu Dr, Buckhannon, WV 26201-9411 | 2012-09-25 |
| 1578811857 | Community Care of West Virginia, Inc. | Clinic/Center | 16 College Ave, Buckhannon, WV 26201-2628 | 2012-08-17 |
| 1255507810 | Community Care of West Virginia, Inc. | Clinic/Center | 4 Northridge Dr Ste 118, Buckhannon, WV 26201-8484 | 2008-05-05 |
| 1487145769 | Community Care of West Virginia, Inc. | Clinic/Center | 59 College Ave, Buckhannon, WV 26201-2600 | 2018-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493499 | Camden On Gauley Medical Center Inc | Clinic/Center | 52 Florence Street, Ansted, WV 25812 | 2020-10-06 |
| 1619503422 | Change Inc | Clinic/Center | 114 Taylor Ave, Weirton, WV 26062-4635 | 2020-03-13 |
| 1861023699 | Logan-mingo Area Mental Health, Inc | Clinic/Center | 2954 Buffalo Creek Road, Chattaroy, WV 25667 | 2020-01-30 |
| 1689220402 | New River Health Association, Inc. | Clinic/Center | 2 Greyhound Ln., Smithers, WV 25186 | 2019-08-16 |
| 1740836873 | Williamson Health & Wellness Center Inc | Clinic/Center | 5 Parkway Dr, Williamson, WV 25661-3428 | 2019-08-14 |
| 1699321729 | Williamson Health & Wellness Center Inc | Clinic/Center | 50 Panther Blvd, Williamson, WV 25661-7441 | 2019-08-14 |
| 1083260129 | Williamson Health & Wellness Center Inc | Clinic/Center | 300 Blue Devil Lane, Kermit, WV 25661 | 2019-08-14 |
| 1225684731 | Williamson Health & Wellness Center Inc | Clinic/Center | 1000 King Coal Hwy, Delbarton, WV 25670-9529 | 2019-08-12 |
| 1669024469 | Womencare Inc | Clinic/Center | 150 Josephine Ave, Madison, WV 25130-1357 | 2019-07-11 |
| 1255983482 | Womencare Inc | Clinic/Center | 1 Learning Way, Foster, WV 25081-9726 | 2019-07-09 |
| Find all providers with the same taxonomy | ||||
| City | BUCKHANNON |
| Zip Code | 26201 |
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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.