TRI-STATE COMMUNITY HEALTH CENTER, INC (NPI# 1659709277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659709277 |
| Entity Type | Organization |
| Organization Name | TRI-STATE COMMUNITY HEALTH CENTER, INC |
| Practice Address |
621 Kelly Rd Cumberland MD 21502-2878 |
| Mailing Address |
109 Rayloc Dr Hancock MD 21750-1518 |
| Practice Telephone | 3017223270 |
| Practice Fax Number | 3016783276 |
| Mailing Telephone | 3016785187 |
| Mailing Fax Number | 3016785797 |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |
| Authorized Official Name | SATRICIA A WOODAL (HR MANAGER) |
| Authorized Official Telephone | 3016785187 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R200178 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MEDICARE FQHC | 211828 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932159464 | Tri-state Community Health Center, Inc | Clinic/Center | 525 Fulton Drive, Mcconnellsburg, PA 17233-1143 | 2006-05-12 |
| 1083055081 | Tri-state Community Health Center, Inc | Clinic/Center | 261 Berkmore Pl, Suite 1a, Berkeley Springs, WV 25411-6247 | 2013-07-08 |
| 1457301939 | Tri-state Community Health Center, Inc | Clinic/Center | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2006-05-12 |
| 1366491201 | Tri-state Community Health Center, Inc | Clinic/Center | 130 W High St, Hancock, MD 21750-1143 | 2006-05-09 |
| 1467401372 | Tri-state Community Health Center, Inc | Clinic/Center | 12502 Willowbrook Road, Ste 550, 5th Flr., Cumberland, MD 21502-6393 | 2006-05-08 |
| Street Address |
621 KELLY RD |
| City | CUMBERLAND |
| State | MD |
| Zip Code | 21502-2878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093714057 | Raymond E Banfer | Family Medicine | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2005-07-20 |
| 1720601313 | Hannah Mackenzie Metz | Registered Nurse | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2020-05-19 |
| 1598135659 | Janell Sioma | Nurse Practitioner | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2015-10-01 |
| 1851780365 | Angelina Musselman | Nurse Practitioner | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2015-01-21 |
| 1841625654 | Danielle Ayers Henchey | Nurse Practitioner | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2013-09-11 |
| 1154684074 | Andrew Wilcox | Family Medicine | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2012-06-18 |
| 1710198494 | Sharmila Matippa | Family Medicine | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2007-05-24 |
| 1275600504 | Michele Kennedy | Family Medicine | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2006-11-30 |
| 1225079098 | Terry Ellen Harvey | Nurse Practitioner | 621 Kelly Rd, Cumberland, MD 21502 | 2006-06-10 |
| 1457301939 | Tri-state Community Health Center, Inc | Clinic/Center | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2006-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174141592 | Upmc Western Maryland Corporation | Clinic/Center | 10700 Leslie Lane, Cumberland, MD 21502 | 2020-07-13 |
| 1669934212 | Ultimate Hearing Solutions Vi, LLC | Durable Medical Equipment & Medical Supplies | 701 Park Street, Queen City Centre, Cumberland, MD 21502 | 2019-04-03 |
| 1114497070 | Dianne Liller | Speech-Language Pathologist | 200 Massachusetts Ave, Cumberland, MD 21502 | 2018-12-04 |
| 1386111409 | Rebecca Anne Stewart | Counselor | 217 Glenn Street, Suite 401, Cumberland, MD 21502 | 2018-10-26 |
| 1396222998 | Crystal Lynne Walls | Nurse Practitioner | Western Maryland Health System, 12500 Willowbrook Rd, Cumberland, MD 21502 | 2018-07-26 |
| 1841796554 | Joan Kathleen Hoban | Speech-Language Pathologist | Potomac Behavioral and Occupational Therapy, 240 Henderson Ave., Cumberland, MD 21502 | 2018-04-02 |
| 1760984447 | Christine T. Haines | Social Worker | 907 Seton Drive, Cumberland, MD 21502 | 2018-03-08 |
| 1033632328 | Nicole Mabury | Counselor | 12501 Willowbrook Road, Cumberland, MD 21502 | 2017-07-19 |
| 1073042479 | The Lions Center for Rehabilitation and Extended Care, Inc. | Skilled Nursing Facility | 901 Seton Drive, Cumberland, MD 21502 | 2017-06-08 |
| 1912446816 | Marina Hurst | Counselor | 10102 County Club Road Se, Cumberland, MD 21502 | 2017-02-13 |
| Find all providers in zip 21502 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001818 | Shannon Nicole Martin | Nurse Practitioner | 924 Seton Dr # C, Cumberland, MD 21502-1851 | 2020-10-21 |
| 1518586478 | Justin Newsome | Nurse Practitioner | 209 Field St, Cumberland, KY 40823-1407 | 2020-04-10 |
| 1669037008 | Proactive Pain and Neurology, LLC | Nurse Practitioner | 925 Bishop Walsh Rd Ste 10, Cumberland, MD 21502-1845 | 2019-05-01 |
| 1043782790 | Prestige Family Healthcare LLC | Nurse Practitioner | 15 S Centre St, Cumberland, MD 21502-3017 | 2018-12-19 |
| 1396222998 | Crystal Lynne Walls | Nurse Practitioner | Western Maryland Health System, 12500 Willowbrook Rd, Cumberland, MD 21502 | 2018-07-26 |
| 1528556503 | Leigh Ann Wiltison | Nurse Practitioner | 15113 Trail Ridge Rd Sw # 11513, Cumberland, MD 21502-5846 | 2018-04-25 |
| 1972943322 | Belinda Hester | Nurse Practitioner | 72 Greene St, Cumberland, MD 21502-2933 | 2013-06-30 |
| 1750680831 | Krista Dawn Self | Nurse Practitioner | 14100 Mcmullen Hwy Sw, Cumberland, MD 21502-5777 | 2011-03-15 |
| 1548410921 | Cheryl K Nelson | Nurse Practitioner | 12401 Willowbrook Rd, Cumberland, MD 21502-2559 | 2008-09-23 |
| 1407973894 | Michele Wagoner | Nurse Practitioner | 1050 W Industrial Blvd Ste 17, Cumberland, MD 21502-4331 | 2007-03-23 |
| Find all providers in CUMBERLAND | ||||
| City | CUMBERLAND |
| Zip Code | 21502 |
Please comment or provide details below to improve the information on TRI-STATE COMMUNITY HEALTH CENTER, INC.
| 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.