PENDLETON COMMUNITY CARE, INC. (NPI# 1346442134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346442134 |
| Entity Type | Organization |
| Organization Name | PENDLETON COMMUNITY CARE, INC. |
| Other Organization Name | NORTH FORK PRIMARY CARE CLINIC |
| Practice Address |
16921 Mountaineer Drive Riverton WV 26814-0101 |
| Mailing Address |
Po Box 101 Riverton WV 26814-0101 |
| Practice Telephone | 3045672101 |
| Practice Fax Number | 3045672102 |
| Mailing Telephone | 3045672101 |
| Mailing Fax Number | 3045672102 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2016-07-19 |
| Authorized Official Name | JAMIE HUDSON (CEO) |
| Authorized Official Telephone | 3043587230 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 51D0661868 | WV | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810006211 | 05 |
| Other Name | Type Code |
|---|---|
| North Fork Primary Care Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427307222 | Pendleton Community Care, Inc. | Clinic/Center | 1 Mott Street, Harman, WV 26270-0014 | 2012-09-07 |
| 1477646693 | Pendleton Community Care, Inc. | Pharmacy | 203 N Main Street, Franklin, WV 26807 | 2006-10-02 |
| 1417931379 | Pendleton Community Care, Inc. | Clinic/Center | 16921 Mountaineer Drive, Riverton, WV 26814-0101 | 2005-12-05 |
| 1265634059 | Pendleton Community Care, Inc. | Clinical Medical Laboratory | 82 Pine St, Franklin, WV 26807-0100 | 2007-06-04 |
| Street Address |
16921 MOUNTAINEER DRIVE |
| City | RIVERTON |
| State | WV |
| Zip Code | 26814-0101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417931379 | Pendleton Community Care, Inc. | Clinic/Center | 16921 Mountaineer Drive, Riverton, WV 26814-0101 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891307229 | Ruth Ann Puffenbarger | Technician | 1199 Bennett Gap Rd, Riverton, WV 26814-8533 | 2020-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1235736299 | Torq Physical Therapy & Associates | Physical Therapist | 600 Main St Ste 8, Riverton, NJ 08077-1400 | 2020-10-02 |
| 1487261707 | Precision Jointcare LLC | Clinic/Center | 12523 S Creek Meadow Rd Ste 109, Riverton, UT 84065-7299 | 2020-09-30 |
| 1174130629 | Jessica Noel Wagner | Nurse Practitioner | 12828 S 3600 W Ste 101, Riverton, UT 84065-6853 | 2020-09-29 |
| 1548876725 | Kenzie Cierra Evans | Behavior Technician | 11721 S 1220 W, Riverton, UT 84065-4109 | 2020-09-22 |
| 1801409651 | Chelsea Leovy Davenport | Social Worker | 1273 W 12600 S Suite 403, Riverton, UT 84065-8410 | 2020-08-30 |
| 1891307229 | Ruth Ann Puffenbarger | Technician | 1199 Bennett Gap Rd, Riverton, WV 26814-8533 | 2020-08-18 |
| 1528678786 | Banner Health Physicians West LLC | Clinic/Center | 2300 Gasser Rd, Riverton, WY 82501-2204 | 2020-08-03 |
| 1699384859 | Walter Conard | Chiropractor | 709 E Fremont Ave, Riverton, WY 82501-4420 | 2020-07-23 |
| 1730707043 | Brennan Fife Bushman | Chiropractor | 2464 W 12600 S Ste 100, Riverton, UT 84065-7274 | 2020-07-13 |
| Find all providers in RIVERTON | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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|---|---|---|---|---|
| 1205491735 | Foundation for Family Life | Clinical Medical Laboratory | 11978 S Redwood Rd Ste C, Riverton, UT 84065-7403 | 2019-05-09 |
| 1184901167 | Springfield Clinic Riverton Lab | Clinical Medical Laboratory | 1275 N 7th St, Suite A, Riverton, IL 62561-9739 | 2011-11-04 |
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| 1720567241 | Tug River Health Association, Inc. | Clinical Medical Laboratory | 512 Mountaineeer Highway, Room 1344, Bradshaw, WV 24874-2487 | 2018-08-07 |
| 1245765684 | Bds Healthcare LLC | Clinical Medical Laboratory | 1451 Earl L Core Rd, Morgantown, WV 26505-0314 | 2017-04-24 |
| 1538608757 | Vitas Laboratory LLC | Clinical Medical Laboratory | 5487 Country Club Rd, Grafton, WV 26354-8762 | 2017-02-21 |
| 1376081612 | Mountaineer Laboratories LLC | Clinical Medical Laboratory | 1337 Virginia St E, Charleston, WV 25301-3011 | 2017-02-07 |
| 1629520853 | Mountaineer Laboratories LLC | Clinical Medical Laboratory | 1410 Jefferson Blvd # B, Point Pleasant, WV 25550-1344 | 2016-11-04 |
| 1831647403 | West Virginia Drug Testing Laboratories | Clinical Medical Laboratory | 108 S Walker St, Princeton, WV 24740-2745 | 2016-09-13 |
| 1811443302 | Reality Check Drug Testing | Clinical Medical Laboratory | 550 N Eisenhower Dr, Beckley, WV 25801-3109 | 2016-08-25 |
| Find all providers with the same taxonomy | ||||
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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.