COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1558752824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558752824 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Other Organization Name | SALEM ELEMENTARY SCHOOL WELLNESS CENTER |
| Practice Address |
Rr 1 Box 10a Salem WV 26426-9703 |
| Mailing Address |
Po Box 217 Rock Cave WV 26234-0217 |
| Practice Telephone | 3043167180 |
| Practice Fax Number | 3049245460 |
| Mailing Telephone | 3049246262 |
| Mailing Fax Number | 3049245460 |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2015-02-09 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING) |
| Authorized Official Telephone | 3045872541 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WV | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Salem Elementary 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 |
RR 1 BOX 10A |
| City | SALEM |
| State | WV |
| Zip Code | 26426-9703 |
| 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 Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1912431818 | 1st Choice Healthcare Inc | Clinic/Center | 172 Highway 62 W, Salem, AR 72576-8059 | 2017-04-18 |
| 1255877858 | Yakima Valley Farm Workers Clinic | Clinic/Center | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2017-01-06 |
| 1568907673 | Lifespring Inc | Clinic/Center | 1321 S Jackson St, Salem, IN 47167-9730 | 2016-12-28 |
| 1467995852 | Yakima Valley Farm Workers Clinic | Clinic/Center | 255 Lancaster Dr Ne, Salem, OR 97301-5155 | 2016-12-02 |
| 1588910384 | North Shore Community Health, Inc | Clinic/Center | 47 Congress St, Salem, MA 01970-7308 | 2012-07-30 |
| 1194082867 | Northwest Human Services, Inc. | Clinic/Center | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2012-04-18 |
| 1821381641 | Community Action Agency of Columbiana County, Inc | Clinic/Center | 2020 E State St, Suite K, Salem, OH 44460-2480 | 2011-05-26 |
| 1104940493 | Southern Jersey Family Medical Centers, Inc. | Clinic/Center | 238 E Broadway, Salem, NJ 08079-1108 | 2007-03-19 |
| Find all providers in SALEM | ||||
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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.