JENNY L MAMTORA (NPI# 1457974396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457974396 |
| Entity Type | Individual |
| Full Name | JENNY L MAMTORA |
| Credential | D.O. |
| Practice Address |
Family Medicine Center 40 Medical Park Suite 401 Wheeling WV 26003 |
| Practice Telephone | 3042433880 |
| Practice Fax Number | 3042433895 |
| Mailing Telephone | 3042433880 |
| Mailing Fax Number | 3042433895 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
FAMILY MEDICINE CENTER 40 MEDICAL PARK SUITE 401 |
| City | WHEELING |
| State | WV |
| Zip Code | 26003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659997641 | Candace Ashley Singh | Student in an Organized Health Care Education/Training Program | Family Medicine Center, 40 Medical Park Suite 401, Wheeling, WV 26003 | 2020-06-25 |
| 1427672419 | Emilia Anna Surzyn | Student in an Organized Health Care Education/Training Program | Family Medicine Center, 40 Medical Park Suite 401, Wheeling, WV 26003 | 2020-06-04 |
| 1740803501 | Alexander Sample | Student in an Organized Health Care Education/Training Program | Family Medicine Center, 40 Medical Park Suite 401, Wheeling, WV 26003 | 2020-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070538 | Ashley Lynn Fleming | Case Manager/Care Coordinator | 442 Woodland Acres Rd, Wheeling, WV 26003 | 2020-10-13 |
| 1982202057 | Tiffany Renee Beck | Behavioral Analyst | 1007 Market Street, Wheeling, WV 26003 | 2020-10-12 |
| 1922620426 | Abbey Lynne Griffith | Speech-Language Pathologist | 199 Co Rd 7/7, Jane Lew, WV 26003 | 2020-05-07 |
| 1801309414 | Amy Wade | Counselor | 2204 Eoff Street, Wheeling, WV 26003 | 2017-11-06 |
| 1053840157 | Syl Solution Marketing | Durable Medical Equipment & Medical Supplies | 800 Hazlett Ave, Wheeling, WV 26003 | 2017-06-12 |
| 1568917334 | Hamed M Motlagh | Dentist | 53 14th St Ste 208, Wheeling, WV 26003 | 2016-08-22 |
| 1922454446 | Carrie Ann Warman | Pharmacist | 200 Mt.dechantal Road, Wheeling, WV 26003 | 2016-05-13 |
| 1447636691 | Ashley M Zando | Nurse Anesthetist, Certified Registered | 109 Mt Wood Road, Wheeling, WV 26003 | 2015-08-10 |
| 1194126441 | John Greaves | Specialist/Technologist | 135 Springdale Ave, Wheeling, WV 26003 | 2014-09-05 |
| 1154747210 | Donald Lee Rebich | Pharmacist | 61-29th Street, Wheeling, WV 26003 | 2014-03-13 |
| Find all providers in zip 26003 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184259269 | Samira Ibrahim | Student in an Organized Health Care Education/Training Program | 32 20th St Ste 400, Wheeling, WV 26003-3746 | 2020-03-09 |
| 1306486188 | Joshua Sangwon Park | Student in an Organized Health Care Education/Training Program | 270 11th St Unit C, Wheeling, IL 60090-2002 | 2020-01-09 |
| 1326589128 | Nicole Tinetti | Student in an Organized Health Care Education/Training Program | 1410 Marcy Ln, Wheeling, IL 60090 | 2017-03-13 |
| 1194112821 | Nikita Krishnaraj Urval | Student in an Organized Health Care Education/Training Program | 333 Oakmont Rd, Wheeling, WV 26003-5615 | 2015-04-21 |
| 1275933053 | Kayla Henderson | Student in an Organized Health Care Education/Training Program | 222 Chapel Rd, Wheeling, WV 26003-4842 | 2014-08-28 |
| 1659997641 | Candace Ashley Singh | Student in an Organized Health Care Education/Training Program | Family Medicine Center, 40 Medical Park Suite 401, Wheeling, WV 26003 | 2020-06-25 |
| 1346864220 | Emma Carter | Student in an Organized Health Care Education/Training Program | 40 Medical Park Ste 401, Wheeling, WV 26003-6392 | 2020-06-05 |
| 1427672419 | Emilia Anna Surzyn | Student in an Organized Health Care Education/Training Program | Family Medicine Center, 40 Medical Park Suite 401, Wheeling, WV 26003 | 2020-06-04 |
| 1740803501 | Alexander Sample | Student in an Organized Health Care Education/Training Program | Family Medicine Center, 40 Medical Park Suite 401, Wheeling, WV 26003 | 2020-05-27 |
| 1801419940 | Brian David Rogers | Student in an Organized Health Care Education/Training Program | 40 Medical Park Ste 406, Wheeling, WV 26003-6392 | 2020-05-23 |
| Find all providers in WHEELING | ||||
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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.