CHRISTAL R STARK (NPI# 1639352602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639352602 |
| Entity Type | Individual |
| Full Name | CHRISTAL R STARK |
| Credential | RN, MSN, C-PNP |
| Practice Address |
400 Fairview Heights Rd Suite 302 Summersville WV 26651-9308 |
| Practice Telephone | 3048727063 |
| Practice Fax Number | 3048727080 |
| Mailing Telephone | 3048727063 |
| Mailing Fax Number | 3048727080 |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2014-08-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
67293 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | STATE LICENSE | 67293 | 01 |
| Street Address |
400 FAIRVIEW HEIGHTS RD SUITE 302 |
| City | SUMMERSVILLE |
| State | WV |
| Zip Code | 26651-9308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760481014 | Jonathan B Dale | Emergency Medicine | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2005-07-19 |
| 1154929388 | Rachel Davis | Pharmacist | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2020-10-10 |
| 1326655838 | Georgiana Lane Jarvis | Pharmacist | 400 Fairview Heights Rd, Summersville, WV 26651 | 2020-09-29 |
| 1417415324 | West Virginia Health Care Cooperative Inc | Urology | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2019-03-10 |
| 1407314313 | West Virginia Health Care Cooperative Inc | Pharmacy | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2019-03-10 |
| 1194283192 | West Virginia Health Care Cooperative Inc | Skilled Nursing Facility | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2019-03-08 |
| 1548728553 | West Virginia Health Care Cooperative Inc | Clinic/Center | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2019-03-08 |
| 1043778319 | West Virginia Health Care Cooperative Inc | Clinical Medical Laboratory | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2019-03-06 |
| 1336692441 | Amy Mann | Nurse Practitioner | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2016-07-26 |
| 1124470778 | Nicholas Emergency Group, Pllc | Physician Assistant | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2016-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061588 | Marcy Nicole Myerholtz | Pharmacist | 700 Northside Drive, Cvs Pharmacy, Summersville, WV 26651 | 2020-10-21 |
| 1104425396 | Travis Giles | Physical Therapy Assistant | 2129 Canvas Nettie Rd, Summersville, WV 26651 | 2020-10-20 |
| 1043837586 | Clorinda L Workman | Registered Nurse | 221 Bright of America Road, Summersville, WV 26651 | 2020-07-01 |
| 1669947222 | Camden On Gauley Medical Center, Inc. | Clinic/Center | 70 Grade School Lane, Summersville, WV 26651 | 2018-10-10 |
| 1902310451 | Carolyn Maxwell Evans | Technician | 554 Ritchie Farm Road, Summersville, WV 26651 | 2017-11-20 |
| 1568904829 | Nicholas Community Action Partnership, Inc | Case Management | 1205 Broad Street, Summersville, WV 26651 | 2016-11-17 |
| 1831645647 | Rachel Hendricks | Psychologist | 400 Old Main Drive, Nicholas County Schools, Summersville, WV 26651 | 2016-08-31 |
| 1831592542 | Vass Vocational Services, In. | Case Manager/Care Coordinator | 304 Bibb Lane, Summersville, WV 26651 | 2014-10-08 |
| 1417229329 | Professional Medical Ultrasonics Inc. | Clinic/Center | 4089 Webster Rd Suite 5, Summersville, WV 26651 | 2012-02-08 |
| 1437426459 | All Med, LLC | Durable Medical Equipment & Medical Supplies | 602 Appalachian Dr., Summersville, WV 26651 | 2011-11-18 |
| Find all providers in zip 26651 | ||||
| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700270436 | Summersville Pediatrics, Inc. | Clinical Nurse Specialist | 142 N Court Square, Webster Springs, WV 26288 | 2015-03-19 |
| 1427201060 | Regina A. Bias | Clinical Nurse Specialist | 600 E Mcdonald Ave, Man, WV 25635-1023 | 2008-10-28 |
| City | SUMMERSVILLE |
| Zip Code | 26651 |
Please comment or provide details below to improve the information on CHRISTAL R STARK.
| 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.