WHITEHALL MEDICAL PLLC (NPI# 1659432631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659432631 |
| Entity Type | Organization |
| Organization Name | WHITEHALL MEDICAL PLLC |
| Practice Address |
177 Middletown Rd Suite 1 Fairmont WV 26554-8216 |
| Practice Telephone | 3043636600 |
| Practice Fax Number | 3043637700 |
| Mailing Telephone | 3043636600 |
| Mailing Fax Number | 3043637700 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2012-05-03 |
| Authorized Official Name | DR. RICHARD E. VASICEK (MEMBER OWNER) |
| Authorized Official Telephone | 3043636600 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 1552 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | GROUP BCBS | 001711083 | 01 |
| WV | 3810006289 | 05 | |
| WV | GROUP | 2411485 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659585263 | Whitehall Medical Pllc | Family Medicine | 60 Roxbury Road, White Hall, WV 26554-3430 | 2007-05-10 |
| Street Address |
177 MIDDLETOWN RD SUITE 1 |
| City | FAIRMONT |
| State | WV |
| Zip Code | 26554-8216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629526553 | Katie Marie Petrisin | Pharmacist | 177 Middletown Rd, Suite #2, Fairmont, WV 26554-8254 | 2016-09-20 |
| 1952772642 | Joel Francis Williams | Nurse Practitioner | 177 Middletown Rd, Suite 1, Fairmont, WV 26554-8254 | 2015-10-07 |
| 1891065207 | Chad Ross Marsh | Nurse Practitioner | 177 Middletown Rd, Ste 1, Fairmont, WV 26554-8254 | 2012-01-03 |
| 1962647719 | Whitehall Pharmacy LLC | Pharmacy | 177 Middletown Rd, Suite 2, Fairmont, WV 26554-8254 | 2008-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497680 | Vanquisha Clay | Technician | 118 Conaway St, Fairmont, WV 26554 | 2020-11-06 |
| 1851903363 | Denise S Greer | Technician | 1029 Prickett Road, Fairmont, WV 26554 | 2020-08-18 |
| 1730790775 | Darla Lee Mcrobie | Technician | 105 C'anna Square, Fairmont, WV 26554 | 2020-08-13 |
| 1376025718 | Jason Batten | Counselor | 621 Maryland Ave, Fairmont, WV 26554 | 2018-09-02 |
| 1437669066 | Ultimate Health & Wellness, LLC | Naturopath | 2862 Whitehall Blvd, Whitehall, WV 26554 | 2017-10-10 |
| 1457872376 | Michele R Lilley | Nurse Practitioner | 177 Middletown Rd, Ste1, Upc Whitehall Medical, Fairmont, WV 26554 | 2017-06-30 |
| 1477906154 | Rebecca Hayes-merrill | Counselor | 212 Adams St., 3rd Floor, Fairmont, WV 26554 | 2016-07-19 |
| 1790173417 | Dennis Michael Lynch | Counselor | 5 Turf Lane, Fairmont, WV 26554 | 2015-01-05 |
| 1336558725 | Nicole Savage | Home Health Aide | 122 Abbott St, Fairmont, WV 26554 | 2014-08-11 |
| 1124434550 | Achuta Ram Aynampudi | Psychiatry & Neurology | 100 Stoney Hill Rd, Fairmont, WV 26554 | 2014-07-07 |
| Find all providers in zip 26554 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747528 | Susan L Cavender M.d. Pllc | General Practice | 1115 Lee St E, Charleston, WV 25301-2412 | 2017-08-25 |
| 1396284428 | Chapmanville Primary Care Clinic | General Practice | 462 Main Street, Chapmanville, WV 25508 | 2017-02-22 |
| 1952855264 | Mountaineer Family Care Center | General Practice | 318 S Mountaineer Hwy, Thornton, WV 26440-7152 | 2016-08-04 |
| 1720433451 | Samir Shah | General Practice | 3005 Jackson Ave, Point Pleasant, WV 25550-1717 | 2016-05-02 |
| 1376958058 | Nadezda Samples | General Practice | 3110 Maccorkle Ave Se Rm 58, Charleston, WV 25304-1210 | 2014-06-21 |
| 1932476249 | William Palmer Zitter | General Practice | 1637 Mccoy Rd, Huntington, WV 25701-4867 | 2011-11-30 |
| 1174806129 | Steven Ira Richman | General Practice | Hc 74 Box 98i, Hinton, WV 25951-9115 | 2011-09-26 |
| 1467749473 | Jung Jin Lee | General Practice | 390 Birch St, Morgantown, WV 26505 | 2011-06-29 |
| 1184914947 | Todd R Myers Md LLC | General Practice | 1113 Washington St, Suite 203, Ravenswood, WV 26164-1020 | 2011-04-13 |
| 1295030674 | Capital Management Services Company | General Practice | 231 Capitol St, Suite 301, Charleston, WV 25301-2200 | 2011-01-17 |
| Find all providers with the same taxonomy | ||||
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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.