ADAM M PENFOLD (NPI# 1023423613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023423613 |
Entity Type | Individual |
Full Name | ADAM M PENFOLD |
Credential | PA-C |
Practice Address |
2373 W Main St Ste 102 Salem WV 26426-7515 |
Mailing Address |
Po Box 392 Salem WV 26426-0392 |
Practice Telephone | 3047822000 |
Practice Fax Number | 3047823102 |
Mailing Telephone | 3047822000 |
Mailing Fax Number | 3047823102 |
Enumeration Date | 2014-06-23 |
Last Update Date | 2014-06-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2610 | WV | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WV | TEMPORARY STATE LICENSE | 2610 | 01 |
Street Address |
2373 W MAIN ST STE 102 |
City | SALEM |
State | WV |
Zip Code | 26426-7515 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083725287 | Jimmie D Hissem | Dentist | 2373 W Main St, Salem, WV 26426-7515 | 2006-08-31 |
1982054698 | Nancy Allen | Nurse Practitioner | 2373 W Main St, Ste 102, Salem, WV 26426-7515 | 2016-06-14 |
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 | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
1639614852 | Gregory Bull | Physician Assistant | 622 Fernwood Dr, Salem, VA 24153-2654 | 2016-12-24 |
1841648862 | Theron J Wiese | Physician Assistant | 1395 Commercial St Se, Salem, OR 97302-4205 | 2016-05-31 |
1922329697 | Charleen Ann Thorburn | Physician Assistant | 22 Keewaydin Dr, Salem, NH 03079-2839 | 2010-06-17 |
1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
1215912712 | Amy Gouley | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2005-12-07 |
1306827100 | William Earle Williams | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2005-11-08 |
1700485224 | Roderick Mao | Physician Assistant | 159 N Broadway, Salem, NH 03079-2136 | 2020-10-26 |
1447719752 | Christine Nicole Jeffries | Physician Assistant | 360 Church St Se, Salem, OR 97301-3796 | 2019-03-16 |
1265999338 | Brolin Johnson | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2019-02-26 |
Find all providers in SALEM |
Please comment or provide details below to improve the information on ADAM M PENFOLD.
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.