MOUNTAIN STATE ENT & FACIAL PLASTIC SURGERY, INC (NPI# 1982604997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982604997 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATE ENT & FACIAL PLASTIC SURGERY, INC |
| Other Organization Name | MOUNTAIN STATE ENT AND FACIAL PLASTIC SURGERY |
| Practice Address |
86 Brookshire Ln Beckley WV 25801-6765 |
| Practice Telephone | 3042552341 |
| Practice Fax Number | 3042552343 |
| Mailing Telephone | 3042552341 |
| Mailing Fax Number | 3042552343 |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2020-03-26 |
| Authorized Official Name | ALBERT JAMES PAINE JR. (OWNER; PRESIDENT) |
| Authorized Official Telephone | 3042552341 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
006769 | WV | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mountain State ENT | Other Name - Individual/Organization |
| Mountain State ENT and Facial Plastic Surgery | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649639048 | Mountain State Ent & Facial Plastic Surgery, Inc | Massage Therapist | 78 Brookshire, Beckley, WV 25801 | 2016-02-15 |
| Street Address |
86 BROOKSHIRE LN |
| City | BECKLEY |
| State | WV |
| Zip Code | 25801-6765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821541889 | Deana Michelle Mccarty | Nurse Practitioner | 86 Brookshire Ln, Beckley, WV 25801-6765 | 2016-07-26 |
| 1881095230 | Lori Ann Ziolkowski | Audiologist | 86 Brookshire Ln, Beckley, WV 25801-6765 | 2014-09-04 |
| 1760443162 | Albert James Paine Jr. | Otolaryngology | 86 Brookshire Ln, Beckley, WV 25801-6765 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835190 | Misty Dawn Chambers | Psychologist | 154 Lagoon Way, Beckley, USA 25801 | 2020-09-15 |
| 1912511437 | Katherine Lynne Mcghee | Technician | 120 Schlager Dr., Beckley, WV 25801 | 2020-09-02 |
| 1255942421 | Tyesha Burger | Technician | 442 Industrial Dr, Beckley, WV 25801 | 2020-08-12 |
| 1053920553 | Angela Sanches | Case Manager/Care Coordinator | 134 Gooseberry Ln, Beckley, WV 25801 | 2020-07-30 |
| 1871119933 | Tiffani Michelle Dale | Counselor | 111 Coral Court, Apt 5, Beckley, WV 25801 | 2020-06-24 |
| 1679046049 | Liberty Dental Centers | Dentist | 102 Galleria Plaza, Beckley, WV 25801 | 2019-01-08 |
| 1952884942 | Susan Rae Rash | Nurse Practitioner | 250 Stanaford Rd Ste 203, Beckley, WV 25801 | 2018-09-14 |
| 1689169039 | Megan Rae Walker | Dentist | 3153 Robert C. Byrd Drive, Beckley, WV 25801 | 2018-06-28 |
| 1104318625 | Mountain State Vascular, Inc. | Surgery | 121 George Street, Beckley, WV 25801 | 2018-05-31 |
| 1356841100 | Harper Road Treatment Center LLC | Family Medicine | 1802 Harper Rd Ste 202, Beckley, WV 25801 | 2018-02-19 |
| Find all providers in zip 25801 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013557982 | Mountaineer Wellness and Recovery Centers LLC | Clinic/Center | 310 George St, Beckley, WV 25801-2653 | 2020-01-08 |
| 1568994259 | Lifeline Addiction Specialists | Clinic/Center | 550 N Eisenhower Dr, Suite B, Beckley, WV 25801-3109 | 2017-03-31 |
| 1447424569 | Asthma Allergy & Immunology Pllc | Clinic/Center | 2962 Robert C. Byrd Drive, Beckley, WV 25801 | 2008-04-18 |
| 1427178763 | Harold E. Harvey II, Md, Pllc | Clinic/Center | 214 Professional Park, Beckley, WV 25801-3624 | 2007-03-30 |
| 1811021892 | Vein Care of The Virginias Pllc | Clinic/Center | 921 W Neville St, Suite 200, Beckley, WV 25801-4360 | 2007-03-14 |
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| 1275150351 | Wv Wellness and Recovery LLC | Clinic/Center | 4 Putnam Village Drive, Hurricane, WV 25526 | 2020-07-06 |
| 1174881916 | West Virginia Dermatology and Skin Surgery Center | Clinic/Center | 4202 Maccorkle Ave Sw Ste 200, South Charleston, WV 25309-1513 | 2012-04-30 |
| 1376829671 | Kidney Specialists, Pllc | Clinic/Center | 176 Health Care Ln Ste A, Martinsburg, WV 25401-4010 | 2011-10-31 |
| 1326166463 | Kanawha Valley Neurology | Clinic/Center | 3847 Teays Valley Rd, Suite D, Hurricane, WV 25526-9622 | 2007-03-27 |
| 1356349161 | Grant Memorial Hospital | Clinic/Center | 1 Hospital Drive, Petersburg, WV 26847 | 2005-07-14 |
| 1346248283 | Grant Memorial Hospital | Clinic/Center | 10 Valley View St, Suite 101, Petersburg, WV 26847-9543 | 2005-07-13 |
| 1609333830 | House of Grace LLC | Clinic/Center | 401 Camden Rd, Huntington, WV 25704-2708 | 2019-02-25 |
| 1811405616 | Holistic, Inc | Clinic/Center | 303 6th Ave, Saint Albans, WV 25177-2838 | 2018-01-15 |
| 1891220695 | Valley Family Medicine Pllc | Clinic/Center | 215 S Louisiana Ave Ste A, Martinsburg, WV 25401-2023 | 2017-04-29 |
| 1750710141 | Neurology Center of Excellence | Clinic/Center | 1004 Tavern Rd, Martinsburg, WV 25401-2864 | 2013-11-05 |
| 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.