COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1164809802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164809802 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Other Organization Name | MOUNTAINEER MIDDLE SCHOOL WELLNESS CENTER |
| Practice Address |
2 Mountaineer Dr Clarksburg WV 26301-5511 |
| Mailing Address |
Po Box 217 Rock Cave WV 26234-0217 |
| Practice Telephone | 3043267620 |
| Practice Fax Number | 3049245460 |
| Mailing Telephone | 3049246262 |
| Mailing Fax Number | 3049245460 |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING) |
| Authorized Official Telephone | 3045872541 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mountaineer Middle School Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 1538711452 | Community Care of West Virginia, Inc. | Clinic/Center | 481 Heavner Grove Rd, Buckhannon, WV 26201-4859 | 2019-07-11 |
| 1710539630 | Community Care of West Virginia, Inc. | Clinic/Center | 5078 Tallmansville Rd, Buckhannon, WV 26201-1687 | 2019-07-11 |
| 1871003178 | Community Care of West Virginia, Inc. | Clinic/Center | 228 Kanawha Avenue, Burnsville, WV 26335 | 2017-10-02 |
| 1053821363 | Community Care of West Virginia, Inc. | Clinic/Center | 55 Little Birch Rd, Sutton, WV 26601-9469 | 2017-10-02 |
| 1609386978 | Community Care of West Virginia, Inc. | Clinic/Center | 15300 Us Highway 33 W, Linn, WV 26384-9322 | 2017-10-02 |
| 1962912261 | Community Care of West Virginia, Inc. | Clinic/Center | 142 Flatwoods Corner Road, Flatwoods, WV 26621 | 2017-10-02 |
| 1811366248 | Community Care of West Virginia, Inc. | Clinic/Center | 501 Bomont Rd, Bomont, WV 25030-9666 | 2015-09-16 |
| 1043686553 | Community Care of West Virginia, Inc. | Clinic/Center | 358 Court Ave, Weston, WV 26452-2008 | 2015-08-19 |
| Street Address |
2 MOUNTAINEER DR |
| City | CLARKSBURG |
| State | WV |
| Zip Code | 26301-5511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539525 | Christina Burnside | Technician | 89 Green Acres, Clarksburg, WV 26301 | 2020-08-18 |
| 1447764907 | Jonathan Moore | Nurse Practitioner | 1 Medical Ctr. Drive, Clarksburg, WV 26301 | 2017-11-20 |
| 1003241936 | Jennifer Destito | Occupational Therapist | 308 E B Saunders Way, Clarksburg, WV 26301 | 2013-09-11 |
| 1215290481 | Dustin James Getz | Dentist | 200 Route 98 Medwood Plaza, Suite 302, Nutter Fort, WV 26301 | 2012-06-21 |
| 1326339987 | Debra Amos | Counselor | 200 Route 98, Nutter Fort, WV 26301 | 2011-04-29 |
| 1649572140 | Amanda Wilfong | Pharmacist | W Pike and Smith St, Clarksburg, WV 26301 | 2010-12-03 |
| 1265661060 | Jaclyn Elsey Rominger | Dentist | 2017 East Pike St, All Smiles Dental LLC, Clarksburg, WV 26301 | 2009-07-14 |
| 1588815732 | Kimberly Sue Waggy | Psychologist | 408 Eb Saunders Way, Clarksburg, WV 26301 | 2008-10-07 |
| 1659521862 | Eyemart Express, Ltd. | Durable Medical Equipment & Medical Supplies | 538 Emily Dr., Space 20, Clarksburg, WV 26301 | 2008-09-24 |
| 1477715753 | Roxanna L Rinehart | Registered Nurse | 1 Med Ctr Dr, Louis A Johnson Vamc, Clarksburg, WV 26301 | 2008-06-27 |
| Find all providers in zip 26301 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669923538 | Community Care of West Virginia,inc. | Clinic/Center | 1349 Shinnston Pike, Clarksburg, WV 26301-6307 | 2016-10-17 |
| 1871041335 | Community Care of West Virginia,inc. | Clinic/Center | 251 Marietta St, Clarksburg, WV 26301-6313 | 2016-09-13 |
| 1346636792 | Community Care of West Virginia, Inc. | Clinic/Center | 1400 N 19th St, Clarksburg, WV 26301-1644 | 2015-04-13 |
| 1851787121 | Community Care of West Virginia Inc | Clinic/Center | 1636 W Pike St, Clarksburg, WV 26301-2361 | 2015-04-13 |
| 1194111468 | Community Care of West Virginia, Inc. | Clinic/Center | 1 Mountaineer Dr, Clarksburg, WV 26301-5511 | 2015-04-13 |
| 1538555891 | Community Care of West Virginia, Inc. | Clinic/Center | 1040 Wilsonburg Rd, Clarksburg, WV 26301-6511 | 2015-04-13 |
| 1356780639 | Community Care of West Virginia, Inc. | Clinic/Center | 1 Eagle Way, Clarksburg, WV 26301-9784 | 2013-06-19 |
| 1619316999 | Community Care of West Virginia, Inc. | Clinic/Center | 443 Lee Ave, Clarksburg, WV 26301-3648 | 2013-06-19 |
| 1053742668 | Community Care of West Virginia, Inc. | Clinic/Center | 700 Oakmound Rd, Clarksburg, WV 26301-9398 | 2013-12-06 |
| 1730386467 | Primary Health Network | Clinic/Center | 29 Saltsburg Rd, Clarksburg, PA 15725-7400 | 2007-06-27 |
| Find all providers in CLARKSBURG | ||||
| City | CLARKSBURG |
| Zip Code | 26301 |
Please comment or provide details below to improve the information on COMMUNITY CARE OF WEST VIRGINIA, INC..
| 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.