EDEN FAMILY PRACTICE INC. (NPI# 1821049776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821049776 |
| Entity Type | Organization |
| Organization Name | EDEN FAMILY PRACTICE INC. |
| Practice Address |
313 Hudgins St Suite 200 Logan WV 25601-3535 |
| Mailing Address |
3306 Bridget Dr Columbus OH 43221-4431 |
| Practice Telephone | 3047529450 |
| Mailing Telephone | 6148769233 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. PATTY RADCLIFFE (CFO) |
| Authorized Official Telephone | 6148769233 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1939 | WV | Allopathic & Osteopathic Physicians |
| Street Address |
313 HUDGINS ST SUITE 200 |
| City | LOGAN |
| State | WV |
| Zip Code | 25601-3535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386159838 | Zeke Edward Davis I | Social Worker | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-06 |
| 1952816753 | Leslie Renee Walker | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-04 |
| 1881109510 | Kimberly M Harvey | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-04 |
| 1245745975 | Holli Cook | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-04 |
| 1568977387 | Jessi Danielle Tomblin | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-04 |
| 1336654060 | Hannah Brooke Vinson | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-04 |
| 1154836880 | Jessica Bailey | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-12-04 |
| 1295249134 | Todd Blackburn | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-11-30 |
| 1386158228 | Diane Faye Gibson | Social Worker | 313 Hudgins St, Logan, WV 25601-3535 | 2017-11-30 |
| 1639683873 | Tiffany Dawn Morrison | Case Manager/Care Coordinator | 313 Hudgins St, Logan, WV 25601-3535 | 2017-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689805 | Appalachian Medical LLC | Durable Medical Equipment & Medical Supplies | 218 Dingess St, Logan, WV 25601 | 2020-11-04 |
| 1184224909 | Pamela Gail Hamlin | Technician | 123 Cassick Street, Logan, WV 25601 | 2020-10-30 |
| 1134607344 | Allyson Christa Mckinney | Occupational Therapy Assistant | 55 Lmmh Center Road, Logan, WV 25601 | 2018-07-31 |
| 1841783727 | Erica Lupson | Nurse Practitioner | 3 Mile Curve, Logan, WV 25601 | 2018-06-14 |
| 1861930836 | Joseph Michael Mounts | Counselor | 312 Hudgins St, Logan, WV 25601 | 2017-02-09 |
| 1932647385 | Melissa Campbell | Occupational Therapy Assistant | Wv-10, Logan, WV 25601 | 2017-02-06 |
| 1356891659 | Brooke Bell | Pharmacist | Route 44 Holden Rd, Logan, WV 25601 | 2016-10-11 |
| 1760886469 | April Workman | Massage Therapist | 19 A Main Avenue, Logan, WV 25601 | 2014-10-09 |
| 1366889081 | Ashley Leann Dingess | Physical Therapy Assistant | 55 Logan Mingo Mental Health, Logan, WV 25601 | 2013-06-04 |
| 1528361466 | Health Care Management, LLC | Pharmacy | 369 George Kostas Drive, Logan, WV 25601 | 2010-12-15 |
| Find all providers in zip 25601 | ||||
| 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 |
|---|---|---|---|---|
| 1881762649 | Bruce A Isaacson | Family Medicine | 550 E 1400 N Ste Z, Logan, UT 84341-2407 | 2006-12-01 |
| 1184634669 | Glenn O Mortensen | Family Medicine | 1750 N 1000 E, Logan, UT 84341-1909 | 2006-08-08 |
| 1295744522 | Michael C Housley | Family Medicine | 500 E 1400 N, Logan, UT 84341-2465 | 2006-08-05 |
| 1477562767 | Ronald Mark Firth | Family Medicine | 1015 E. 100 N., Logan, UT 84321 | 2006-08-05 |
| 1093723835 | David N N Casey | Family Medicine | 412 N. 200 E., Logan, UT 84321 | 2006-08-04 |
| 1104830884 | Nathan H Call | Family Medicine | 1652 S Main St, Logan, UT 84321-8504 | 2006-07-28 |
| 1033156849 | Brant Wahlen Fonnesbeck | Family Medicine | 550 E 1400 N Ste K, Logan, UT 84341-2450 | 2006-06-01 |
| 1114981024 | Ernesto Manuel | Family Medicine | 396 Dingess St, Logan, WV 25601-3624 | 2006-04-17 |
| 1295724359 | David L Cummin | Family Medicine | 751 State Route 664 N, Logan, OH 43138-9250 | 2005-10-20 |
| 1235133091 | James R Hayward | Family Medicine | 819 State Route 664 N, Ste A, Logan, OH 43138-8540 | 2005-06-09 |
| Find all providers in LOGAN | ||||
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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.