COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1326434846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326434846 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Other Organization Name | BRIDGEPORT HIGH SCHOOL WELLNESS CENTER |
| Practice Address |
515 Johnston Avenue Bridgeport WV 26330-1311 |
| Mailing Address |
Po Box 147 Clay WV 25043-0147 |
| Practice Telephone | 3043267137 |
| Practice Fax Number | 3045872594 |
| Mailing Telephone | 3045872541 |
| Mailing Fax Number | 3045872594 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING) |
| Authorized Official Telephone | 3045872541 |
| 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 |
| Other Name | Type Code |
|---|---|
| Bridgeport High School Wellness Center | 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 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 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 |
| Street Address |
515 JOHNSTON AVENUE |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| 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 |
|---|---|---|---|---|
| 1073169835 | Great Lakes Bay Health Centers | Clinic/Center | 4691 Bearcat Blvd, Bridgeport, MI 48722-9581 | 2019-08-16 |
| 1700252764 | Community Care of West Virginia, Inc. | Clinic/Center | 250 Worthington Dr, Bridgeport, WV 26330-1449 | 2015-08-13 |
| 1669868931 | Community Care of West Virginia, Inc. | Clinic/Center | 413 Johnson Ave, Bridgeport, WV 26330-1309 | 2015-04-13 |
| 1912392358 | Community Care of West Virginia, Inc. | Clinic/Center | 531 Johnson Ave, Bridgeport, WV 26330-1311 | 2015-04-02 |
| 1497176390 | Family Health Centers | Clinic/Center | 1015 Columbia Ave, Bridgeport, WA 98813 | 2013-12-18 |
| 1235485236 | Optimus Health Care Inc | Clinic/Center | 3180 Main St Ste G1, Bridgeport, CT 06606-4237 | 2012-07-27 |
| 1346516317 | Optimus Health Care Inc | Clinic/Center | 1071 E Main St, Bridgeport, CT 06608-1618 | 2012-03-23 |
| 1619348844 | Community Care of West Virginia, Inc. | Clinic/Center | 65 Professional Pl Ste 102103, Bridgeport, WV 26330-0258 | 2015-10-14 |
| 1659641363 | Optimus Health Care Inc | Clinic/Center | 982 E Main St, Bridgeport, CT 06608-1913 | 2012-01-11 |
| 1932479409 | Optimus Health Care Inc | Clinic/Center | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2011-12-30 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
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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.