BLUEFIELD GASTROENTEROLOGY PLLC (NPI# 1093869968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093869968 |
| Entity Type | Organization |
| Organization Name | BLUEFIELD GASTROENTEROLOGY PLLC |
| Practice Address |
405 12th Street Ext Princeton WV 24740-2300 |
| Practice Telephone | 3044257243 |
| Practice Fax Number | 3044873525 |
| Mailing Telephone | 3044257243 |
| Mailing Fax Number | 3044873525 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-11-21 |
| Authorized Official Name | MR. KAMALESH P PATEL (OWNER) |
| Authorized Official Telephone | 3044257243 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BLUECROSS BLUESHIELD | 1807132 | 01 |
| WV | 3810004352 | 05 | |
| WV | RAILROAD MEDICARE | CK3736 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Bluefield Gastroenterology PLLC | 405 12th St Extension, Princeton, West Virginia 24315 |
| Street Address |
405 12TH STREET EXT |
| City | PRINCETON |
| State | WV |
| Zip Code | 24740-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518067024 | Michele E Smith | Nurse Anesthetist, Certified Registered | 405 12th Street Ext, Princeton, WV 24740 | 2006-09-24 |
| 1831529247 | Shannon Nickole Johns | Nurse Practitioner | 405 12th Street Ext, Princeton, WV 24740-2300 | 2013-11-21 |
| 1619273232 | Linda Sue Mooney | Nurse Practitioner | 405 12th Street Ext, Princeton, WV 24740-2300 | 2011-01-28 |
| 1366748980 | Melody Ponce' | Nurse Practitioner | 405 12th Street Ext, Princeton, WV 24740-2300 | 2011-01-28 |
| 1861654576 | Beverly L Whitt | Nurse Practitioner | 405 12th Street Ext, Princeton, WV 24740-2300 | 2008-06-25 |
| 1750472817 | Kamalesh P Patel | Internal Medicine | 405 12th Street Ext, Princeton, WV 24740-2300 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658632 | New Beginnings Therapy Services, LLC | Community/Behavioral Health | 616 Harrison Street, Princeton, WV 24740 | 2020-10-27 |
| 1215536222 | Right At Home | Home Health | 313 Locus St, Princeton, WV 24740 | 2020-10-21 |
| 1881208098 | Robin Lane | Technician | 174 Tea Kettle Road, Princeton, WV 24740 | 2020-09-04 |
| 1134739824 | Nona Arthur | Technician | 708 Bluefiled Ave, Princeton, WV 24740 | 2020-08-06 |
| 1851909014 | Tina B Altizer | Speech-Language Pathologist | 120 12th Street, Princeton, WV 24740 | 2020-07-14 |
| 1245712504 | Tracy Jean Mitchell | Speech-Language Pathologist | 1200 Mercer St, Princeton, WV 24740 | 2018-09-04 |
| 1700305240 | Tina Six | Registered Nurse | 1403 Honaker Avenue, Princeton, WV 24740 | 2017-09-15 |
| 1013449172 | Karin Cappa | Pharmacist | 669 Cornfield Rd, Princeton, WV 24740 | 2017-03-29 |
| 1942661723 | Virginia Chryssikos | Social Worker | 3016 E Cumberland Road, Bluestone Family Practice, Bluefield, WV 24740 | 2016-03-08 |
| 1477939460 | Kathy Diane Wyrick | Counselor | 220 South Walker Street, Princeton, WV 24740 | 2015-08-03 |
| Find all providers in zip 24740 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1982983995 | Steven Lee Collins | Specialist | 313 Court House Road Suite 2, Princeton, WV 24739 | 2011-08-08 |
| 1558652297 | Steven Lee Terry | Specialist | 201 Wallace St, Princeton, WV 24740-2754 | 2011-04-28 |
| 1366671745 | Bonnie G Carter | Specialist | 108 Mill St, Princeton, ME 04668-3344 | 2009-07-07 |
| 1407080229 | Valeria Malone Jones | Specialist | 116 S. Center St., Princeton, NC 27569 | 2009-05-07 |
| 1760641757 | Ivy League Health & Fitness | Specialist | 66 Witherspoon St, Princeton, NJ 08542-3239 | 2008-06-04 |
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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.