COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1558563734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558563734 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Other Organization Name | WEST MILFORD COMMUNITY HEALTH CENTER |
| Practice Address |
597 Liberty St West Milford WV 26451-6801 |
| Practice Telephone | 3047454568 |
| Practice Fax Number | 3043263700 |
| Mailing Telephone | 3047454568 |
| Mailing Fax Number | 3043263700 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 3043177275 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1558563734 | 05 |
| Other Name | Type Code |
|---|---|
| West Milford Community Health 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 |
597 LIBERTY ST |
| City | WEST MILFORD |
| State | WV |
| Zip Code | 26451-6801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578176228 | Vanessa Short | Social Worker | 597 Liberty St, West Milford, WV 26451-6801 | 2020-08-24 |
| 1679901243 | Matya Drennen | Nurse Practitioner | 597 Liberty St, West Milford, WV 26451-6801 | 2013-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417352287 | Candis M Toothman | Nurse Practitioner | 597 Libert Street, Suite 15, West Milford, WV 26451 | 2014-10-23 |
| 1801186853 | Christina L Nolte | Physician Assistant | 597 Liberty Street, West Milford, WV 26451 | 2011-04-12 |
| 1376644401 | Denzil W Hawkinberry II | Anesthesiology | 924 Liberty Street, West Milford, WV 26451 | 2006-09-25 |
| 1417212952 | Stephanie Marie Smith | Nurse Practitioner | 924 Liberty Street, West Milford, WV 26451 | 2012-07-11 |
| 1093939183 | Jason S. Kidd | Physician Assistant | 924 Liberty Street, West Milford, WV 26451 | 2007-04-12 |
| 1730166596 | Robert William Benson | Counselor | Star Trek Drive, West Milford, WV 26451-0154 | 2005-12-22 |
| 1891830469 | Deana Mae Morrison Fernandez | Chiropractor | 620 Main Street, West Milford, WV 26451-0263 | 2007-02-21 |
| 1821349309 | Community Care of West Virginia, Inc. | Clinic/Center | 226 School St, West Milford, WV 26451-9700 | 2012-09-25 |
| 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 |
|---|---|---|---|---|
| 1821349309 | Community Care of West Virginia, Inc. | Clinic/Center | 226 School St, West Milford, WV 26451-9700 | 2012-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493499 | Camden On Gauley Medical Center Inc | Clinic/Center | 52 Florence Street, Ansted, WV 25812 | 2020-10-06 |
| 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 |
| 1619503422 | Change Inc | Clinic/Center | 114 Taylor Ave, Weirton, WV 26062-4635 | 2020-03-13 |
| 1861023699 | Logan-mingo Area Mental Health, Inc | Clinic/Center | 2954 Buffalo Creek Road, Chattaroy, WV 25667 | 2020-01-30 |
| 1689220402 | New River Health Association, Inc. | Clinic/Center | 2 Greyhound Ln., Smithers, WV 25186 | 2019-08-16 |
| 1740836873 | Williamson Health & Wellness Center Inc | Clinic/Center | 5 Parkway Dr, Williamson, WV 25661-3428 | 2019-08-14 |
| 1699321729 | Williamson Health & Wellness Center Inc | Clinic/Center | 50 Panther Blvd, Williamson, WV 25661-7441 | 2019-08-14 |
| 1083260129 | Williamson Health & Wellness Center Inc | Clinic/Center | 300 Blue Devil Lane, Kermit, WV 25661 | 2019-08-14 |
| 1225684731 | Williamson Health & Wellness Center Inc | Clinic/Center | 1000 King Coal Hwy, Delbarton, WV 25670-9529 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | WEST MILFORD |
| Zip Code | 26451 |
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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.