DR. CHARLES H.M. JACQUES (NPI# 1073577524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073577524 |
| Entity Type | Individual |
| Full Name | DR. CHARLES H.M. JACQUES |
| Credential | M.D. |
| Practice Address |
5722 Cabin Creek Rd Dawes WV 25054-0000 |
| Mailing Address |
Po Box 70 Dawes WV 25054-0070 |
| Practice Telephone | 3045955006 |
| Practice Fax Number | 3045952054 |
| Mailing Telephone | 3047342040 |
| Mailing Fax Number | 3047342047 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 17181 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0053482000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083815583 | Charles G Jacques IIi | Counselor | 8017 Jefferson Hwy Ste A3, Baton Rouge, LA 70809-1681 | 2007-05-30 |
| 1669920542 | Charles Edmund Jacques | Counselor | 50 Pleasant St, Northampton, MA 01060-3909 | 2016-09-20 |
| Street Address |
5722 CABIN CREEK RD |
| City | DAWES |
| State | WV |
| Zip Code | 25054-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245744606 | Alexandrina Maria Gomes | Psychologist | 5722 Cabin Creek Rd, Dawes, WV 25054-7700 | 2017-11-21 |
| 1457892705 | Dannel Karl Petgrave | Psychologist | 5722 Cabin Creek Rd, Dawes, WV 25054 | 2017-03-19 |
| 1134582281 | Sarah Hansen | Registered Nurse | 5722 Cabin Creek Rd, Dawes, WV 25054 | 2016-04-05 |
| 1821465980 | Emily Anne Walker | Pharmacist | 5722 Cabin Creek Rd, Dawes, WV 25054-7700 | 2015-08-25 |
| 1457754988 | Cabin Creek Health Center Lab | Family Medicine | 5722 Cabin Creek Rd, Dawes, WV 25054 | 2014-09-29 |
| 1487886305 | Ashley Portz | Physician Assistant | 5722 Cabin Creek Rd, Dawes, WV 25054-7700 | 2009-08-11 |
| 1710942735 | Eric Ethon Stollings | Physician Assistant | 5722 Cabin Creek Rd, Dawes, WV 25054-0070 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336467117 | Debora Jean Bail | Pharmacist | 5722 Cabin Creek Drive, Dawes, WV 25054 | 2010-05-04 |
| 1225257850 | Cabin Creek Health Center, Inc. | Clinical Medical Laboratory | State Rte 79, Dawes, WV 25054 | 2007-04-24 |
| 1225194848 | Amy Wayne Brabbin | Pharmacist | State Route 79, Dawes, WV 25054 | 2006-12-28 |
| 1306921556 | Sue Ann Westfall | Family Medicine | 5722 Cabin Creek Road, Suite A, Dawes, WV 25054 | 2006-10-26 |
| 1306838685 | Brian E Sayre | Pharmacist | Sr 79, Dawes, WV 25054 | 2005-08-22 |
| 1912440652 | Tiffany Hughes | Nurse Practitioner | 5722 Cabin Creek Road, Dawes, WV 25054 | 2016-11-29 |
| 1972994788 | Jerad Lee Bailey | Pharmacist | 5722 Cabin Creek Road, Dawes, WV 25054 | 2015-02-16 |
| 1083850382 | Megan Olish-terry | Physician Assistant | Route 79, Dawes, WV 25054 | 2008-12-17 |
| 1487709655 | Debra A. Bostic | Nurse Practitioner | Route 79, Dawes, WV 25054 | 2007-01-25 |
| 1740367325 | Byron Menking Hoggatt | Nurse Practitioner | 5722 Cabin Creek Road, Dawes, WV 25054 | 2006-11-01 |
| Find all providers in zip 25054 | ||||
| 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 |
|---|---|---|---|---|
| 1306921556 | Sue Ann Westfall | Family Medicine | 5722 Cabin Creek Road, Suite A, Dawes, WV 25054 | 2006-10-26 |
| 1457754988 | Cabin Creek Health Center Lab | Family Medicine | 5722 Cabin Creek Rd, Dawes, WV 25054 | 2014-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652868 | Grace Health Care Pllc | Family Medicine | 223 5th Ave, Huntington, WV 25701-1809 | 2020-09-02 |
| 1356954259 | Relymd Medical Group Wv, Pllc | Family Medicine | 1627 Quarrier St, Charleston, WV 25311-2124 | 2020-08-28 |
| 1174133243 | Jacqulyn Marie Sheppard | Family Medicine | 2647 Raceview Dr, Ona, WV 25545-9636 | 2020-08-04 |
| 1194341594 | E. A. Hawse Health Center, Inc. | Family Medicine | Romney Elementary School, 45 School Street, Romney, WV 26757 | 2020-06-22 |
| 1730705328 | E. A. Hawse Health Center, Inc. | Family Medicine | Romney Middle School, 296 Calvert Drive, Romney, WV 26757 | 2020-06-19 |
| 1437775251 | E. A. Hawse Health Center, Inc. | Family Medicine | Hampshire High School, 157 Trojan Way, Romney, WV 26757-6317 | 2020-06-17 |
| 1235753286 | Community Health Association | Family Medicine | 146 Pinnell St, Ripley, WV 25271-9101 | 2020-06-05 |
| 1871114546 | Family Care Plus Pllc | Family Medicine | 320 Red Oaks Shopping Ctr, Ronceverte, WV 24970-1364 | 2020-05-04 |
| 1073142733 | Total Health and Recovery Clinic, LLC | Family Medicine | 1824 Murdoch Ave Bldg F Suite201, Parkersburg, WV 26101-3230 | 2020-04-05 |
| 1437780269 | Healthcare 360 Pllc | Family Medicine | 208 Dawkins Drive, Lewisburg, WV 24901 | 2020-01-30 |
| 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.