PRESTIGE PRIMARY CARE ASSOCIATES, PLLC (NPI# 1790819373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790819373 |
| Entity Type | Organization |
| Organization Name | PRESTIGE PRIMARY CARE ASSOCIATES, PLLC |
| Practice Address |
4501 Maccorkle Ave Sw Suite 301 South Charleston WV 25309-1444 |
| Practice Telephone | 3047680700 |
| Practice Fax Number | 3047689790 |
| Mailing Telephone | 3047680700 |
| Mailing Fax Number | 3047689790 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-10-16 |
| Authorized Official Name | DR. FRANKLIN SCOTT MOORE (OWNER) |
| Authorized Official Telephone | 3047680700 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 1390 | WV | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 1212 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810007578 | 05 |
| Street Address |
4501 MACCORKLE AVE SW SUITE 301 |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386639243 | Larry Douglas Curnutte | Obstetrics & Gynecology | 4501 Maccorkle Ave Sw, Suite 200, South Charleston, WV 25309-1444 | 2005-09-16 |
| 1821453192 | Bee Well Pharmacy Inc. | Pharmacy | 4501 Maccorkle Ave Sw, South Charleston, WV 25309-1444 | 2015-12-30 |
| 1811161524 | Woman Care Clinic Inc | Obstetrics & Gynecology | 4501 Maccorkle Ave Sw, Suite 200, South Charleston, WV 25309-1444 | 2008-04-15 |
| 1215126990 | Comprecare Services, Inc | Durable Medical Equipment & Medical Supplies | 4501 Maccorkle Ave Sw, Suite 101, South Charleston, WV 25309-1444 | 2007-10-18 |
| 1649476169 | Michael L. Harris Md, Ltd | Eyewear Supplier (Equipment, not the service) | 4501 Maccorkle Ave Sw, Suite 500, South Charleston, WV 25309-1444 | 2007-06-22 |
| 1952429813 | Mouwafak Ghannam | Specialist | 4501 Maccorkle Ave Sw, Suite 401, South Charleston, WV 25309-1444 | 2007-03-27 |
| 1174649347 | Metamorphosis Counseling, Inc | Counselor | 4501 Maccorkle Ave Sw, Suite 103, South Charleston, WV 25309-1444 | 2007-03-21 |
| 1841373529 | Gary D Harris | Audiologist | 4501 Maccorkle Ave Sw, Suite 402, South Charleston, WV 25309-1444 | 2006-10-24 |
| 1730260399 | Michael L. Harris, M.d., Ltd. | Ophthalmology | 4501 Maccorkle Ave Sw, Suite 500, South Charleston, WV 25309-1444 | 2006-10-18 |
| 1841388550 | Randall Alan Clifford | Counselor | 4501 Maccorkle Ave Sw, Ste 103, South Charleston, WV 25309-1444 | 2006-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003213471 | Neveah Health & Wellness Center, Pllc | Family Medicine | 538 3rd Avenue, South Charleston, WV 25303 | 2014-12-01 |
| 1376967471 | Camc Urgent Care Southridge | Family Medicine | 301 Rhl Ste 3, South Charleston, WV 25309-8275 | 2014-02-10 |
| 1578908703 | Patel Inc. | Family Medicine | 129 7th Ave, South Charleston, WV 25303-1417 | 2013-05-01 |
| 1467535450 | Patel & Patel Md Inc | Family Medicine | 401 Division St Ste 306, South Charleston, WV 25309-1455 | 2006-10-23 |
| 1073547097 | Adam J Breinig | Family Medicine | 1563 Sand Plant Rd, South Charleston, WV 25309-6120 | 2006-07-10 |
| 1598792202 | Delberta S Riffe | Family Medicine | 312 6th Ave Sw, Suite 3, South Charleston, WV 25303-1242 | 2006-06-27 |
| 1962453191 | Crystal H Bastin | Family Medicine | 4820 Kentucky St, South Charleston, WV 25309 | 2006-05-12 |
| 1568420586 | Richard D Hayes, Jr | Family Medicine | 312 6th Ave, Suite 3, South Charleston, WV 25303-1265 | 2006-05-01 |
| 1821058348 | Paul Timothy Kuryla | Family Medicine | 400 Division St Ste 6, South Charleston, WV 25309-1459 | 2006-03-27 |
| 1730174145 | D Duane Berry | Family Medicine | 5220 Maccorkle Ave Sw, South Charleston, WV 25309-1010 | 2005-09-13 |
| Find all providers in SOUTH CHARLESTON | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
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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.