CABIN CREEK HEALTH CENTER, INC. (NPI# 1588908362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588908362 |
| Entity Type | Organization |
| Organization Name | CABIN CREEK HEALTH CENTER, INC. |
| Other Organization Name | KANAWHA CITY HEALTH CENTER |
| Practice Address |
4602 Maccorkle Ave Se Charleston WV 25304-1848 |
| Mailing Address |
Po Box 70 Dawes WV 25054-0070 |
| Practice Telephone | 3047342040 |
| Practice Fax Number | 3047342047 |
| Mailing Telephone | 3047342040 |
| Mailing Fax Number | 3047342047 |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |
| Authorized Official Name | JENNIFER RUSSELL (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 3047342040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
1041-6374 | WV | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kanawha City Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821377292 | Cabin Creek Health Center, Inc. | Clinic/Center | 1st & Brannon Street, East Bank, WV 25067-9752 | 2011-08-16 |
| 1780962340 | Cabin Creek Health Center, Inc. | Clinic/Center | 6100 Sissonville Dr, Charleston, WV 25312-9444 | 2011-08-01 |
| 1225257850 | Cabin Creek Health Center, Inc. | Clinical Medical Laboratory | State Rte 79, Dawes, WV 25054 | 2007-04-24 |
| 1538214077 | Cabin Creek Health Center, Inc. | Clinic/Center | 1 Warrior Way, Suite 103, Belle, WV 25015-1358 | 2007-01-24 |
| 1437199742 | Cabin Creek Health Center, Inc. | Clinic/Center | 107 Koontz Ave., Suite 200, Clendenin, WV 25045 | 2006-06-07 |
| 1366495525 | Cabin Creek Health Center, Inc. | Clinic/Center | Route 79, Dawes, WV 25054-0070 | 2006-05-18 |
| 1063932929 | Cabin Creek Health Center, Inc. | Clinic/Center | 108 Lee St E, Charleston, WV 25301-1506 | 2017-06-22 |
| Street Address |
4602 MACCORKLE AVE SE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-1848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417945304 | Donald L Seidler | Emergency Medicine | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2005-10-13 |
| 1841806510 | Ashley Sierra Copen | Social Worker | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2020-09-18 |
| 1225656044 | Marlee Layh | Student in an Organized Health Care Education/Training Program | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2020-07-08 |
| 1689040032 | Rocky Lucas | Social Worker | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2015-08-19 |
| 1861895427 | Cabin Creek Health Center Inc. | Family Medicine | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2014-09-26 |
| 1750726444 | Wv Rural Healthcare Partnership | Pharmacy | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2013-05-08 |
| 1285988808 | Karen Lynn Bailey | Physician Assistant | 4602 Maccorkle Ave Se, 81 Lincoln Panther Way, Charleston, WV 25304-1848 | 2012-11-05 |
| 1679865687 | Grace Mcclung Falbo | Family Medicine | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2011-05-09 |
| 1760702120 | Ryan Morrison | Internal Medicine | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2010-06-09 |
| 1861693194 | Integrated Health Care Providers, Inc. | Clinic/Center | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2007-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1790276525 | Womencare Inc | Clinic/Center | 812 Park Ave # 35, Charleston, WV 25302 | 2018-05-29 |
| 1447741236 | Womencare Inc | Clinic/Center | 1500 Greenbrier St # 160, Charleston, WV 25311-1007 | 2018-05-29 |
| 1760920987 | Womencare Inc | Clinic/Center | 501 Stockton St, Charleston, WV 25387-2429 | 2017-02-08 |
| 1871872184 | Womencare Inc | Clinic/Center | 100 Florida Street, Charleston, WV 25302-1131 | 2011-08-04 |
| 1780962340 | Cabin Creek Health Center, Inc. | Clinic/Center | 6100 Sissonville Dr, Charleston, WV 25312-9444 | 2011-08-01 |
| 1770745036 | Womencare Inc | Clinic/Center | 108 Washington St W Ste 201, Charleston, WV 25302-2344 | 2008-06-27 |
| 1679190771 | Fetter Health Care Network, Inc | Clinic/Center | 51 Nassau St, Charleston, SC 29403-5513 | 2020-07-06 |
| 1194211243 | Fetter Health Care Network, Inc. | Clinic/Center | 51 Nassau St, Charleston, SC 29403 | 2018-07-02 |
| 1982124301 | Fetter Health Care Network, Inc. | Clinic/Center | 35 Walnut St, Charleston, SC 29403-4514 | 2017-06-27 |
| 1245639095 | Fetter Health Care Network Inc | Clinic/Center | 700 Rutledge Ave, Charleston, SC 29403-4145 | 2014-08-18 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
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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.