CONCORD UNIVERSITY (NPI# 1194287565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194287565 |
| Entity Type | Organization |
| Organization Name | CONCORD UNIVERSITY |
| Practice Address |
1000 Vermillion St Athens WV 24712-9027 |
| Mailing Address |
5050 Spring Valley Rd Dallas TX 75244-3995 |
| Practice Telephone | 3043847325 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |
| Authorized Official Name | MOUZON BASS III (ADMINISTRATOR/AGENT) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Concord Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033601943 | Concord University | Emergency Medicine | 1000 Vermillion St, Athens, WV 24712-9027 | 2018-06-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CONCORD UNIVERSITY | 1000 Vermillion St, Athens, WV 24712-9027 |
| System for Award Management (SAM) Entities | CONCORD UNIVERSITY RESEARCH AND DEVELOPMENT CORPORATION | 1000 Vermillion St, Athens, WV 24712-9027 |
| Street Address |
1000 VERMILLION ST |
| City | ATHENS |
| State | WV |
| Zip Code | 24712-9027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609158559 | John Charles Roberts Jr. | Specialist/Technologist | 1000 Vermillion St, Concord University, Athens, WV 24712-9027 | 2011-09-16 |
| 1407487762 | Taylor Isabelle Walker | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2020-01-27 |
| 1255962502 | Katelyn Golinsky | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2020-01-27 |
| 1881225134 | Lauren Richardson | Student in an Organized Health Care Education/Training Program | 1000 Vermillion St, Athens, WV 24712-9027 | 2020-01-27 |
| 1962033217 | Kaitlyn Stewart | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2020-01-27 |
| 1508497868 | Lauren Nicole Kerekes | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2020-01-27 |
| 1417588773 | Jesse Lilly | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2020-01-27 |
| 1548809312 | Armando S. Frutos Jr. | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2019-12-27 |
| 1073151858 | Taylor Rae Thompson | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2019-12-12 |
| 1801352315 | Abigail Katharine Beatty | Specialist/Technologist | 1000 Vermillion St, Athens, WV 24712-9027 | 2019-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649771809 | Brandy Lea Morrison | Specialist/Technologist | Concord University 1000 Vemillion Street, Athens, WV 24712 | 2018-02-23 |
| 1801330915 | Cami Maxwell | Nurse Practitioner | 274 Nelsie Lane, Athens, WV 24712 | 2016-12-08 |
| 1073056529 | Tracy Leigh Mccallister Gill | Specialist/Technologist | 1000 Vermillion St., Athens, WV 24712 | 2016-11-30 |
| 1578789731 | Natasha Nicola Barker | Physician Assistant | 401 Vermillion Street, Athens, WV 24712 | 2007-04-17 |
| 1508969262 | West Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 105 South State St, Athens, WV 24712 | 2006-09-07 |
| 1972610863 | Princeton Community Hospital Assn., Inc | Family Medicine | 401 Vermillion St., Athens, WV 24712 | 2006-08-24 |
| 1295763050 | Jennifer Lynn Hvozdovic Koerber | Specialist/Technologist | 1000 Vermillion Street, Campus Box 77, Athens, WV 24712 | 2006-06-29 |
| 1265889844 | Mark Allen Yost | Family Medicine | 401 Vermillion Street, Athens, WV 24712-0697 | 2016-05-24 |
| 1801996657 | Charles Edward Lane Jr. | Dentist | State Route 20 North, Athens, WV 24712-0915 | 2006-09-22 |
| 1972110781 | Jessica Ann Thompson | Technician | 110 Vermillion St Apt 8, Athens, WV 24712-1130 | 2020-09-25 |
| Find all providers in zip 24712 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386261162 | Kayla Elizabeth Moore | Physician Assistant | 1477 Cotton Hollow Rd, Athens, PA 18810-7769 | 2020-06-29 |
| 1053934844 | William Aaron Retterbush | Physician Assistant | 250 W Broad St Apt 624, Athens, GA 30601-4817 | 2020-05-27 |
| 1689219552 | Katie Rhea Collins | Physician Assistant | 2400 Denso Dr, Athens, TN 37303-7835 | 2019-11-14 |
| 1538535984 | Tina Beatty | Physician Assistant | 146 Parks Hall, Athens, OH 45701-1359 | 2015-08-19 |
| 1811325673 | Janna Leigh Baker | Physician Assistant | 1000 Hawthorne Ave Ste T, Athens, GA 30606-2168 | 2013-10-14 |
| 1639457716 | Kara Renee Whyte | Physician Assistant | 242 King Ave, Medical Services Building, 2nd Floor, Athens, GA 30606-3506 | 2011-07-24 |
| 1336367671 | Robert Kevin Chin | Physician Assistant | 711 Cook Dr Ste 100, Athens, TN 37303-3499 | 2007-04-23 |
| 1578789731 | Natasha Nicola Barker | Physician Assistant | 401 Vermillion Street, Athens, WV 24712 | 2007-04-17 |
| 1124184742 | Mara Renee Franklin | Physician Assistant | 1450 Barnett Shoals Rd Ste B, Athens, GA 30605-2748 | 2006-12-28 |
| 1750313854 | Emergency Professionals of Ohio, Inc. | Physician Assistant | 55 Hospital Drive, Athens, OH 45701-2345 | 2006-07-07 |
| Find all providers in ATHENS | ||||
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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.