LINCOLN COUNTY PRIMARY CARE CENTER INC (NPI# 1720586472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720586472 |
| Entity Type | Organization |
| Organization Name | LINCOLN COUNTY PRIMARY CARE CENTER INC |
| Other Organization Name | SOUTHERN WEST VIRGINIA HEALTH SYSTEM-MADISON MEDICAL |
| Practice Address |
471 Main St Madison WV 25130-1223 |
| Mailing Address |
7400 Lynn Ave Hamlin WV 25523-1138 |
| Practice Telephone | 3043695170 |
| Practice Fax Number | 3043690946 |
| Mailing Telephone | 3048245806 |
| Mailing Fax Number | 3048245804 |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-10-02 |
| Authorized Official Name | LETITIA ANN WEAVER (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 3048245806 |
| Is Organization Subpart | Y |
| Parent Organization Name | LINCOLN COUNTY PRIMARY CARE CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1720586472 | 05 |
| Other Name | Type Code |
|---|---|
| Southern West Virginia Health System-Madison Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770589681 | Lincoln County Primary Care Center Inc | Pharmacy | 6 1st St, Hamlin, WV 25523-1162 | 2005-06-24 |
| 1477174035 | Lincoln County Primary Care Center Inc | Clinic/Center | 600 E Mcdonald Ave, Man, WV 25635-1023 | 2020-05-05 |
| 1467925487 | Lincoln County Primary Care Center Inc | Pharmacy | 202 Larry Joe Harless Dr, Gilbert, WV 25621 | 2019-01-03 |
| 1790257798 | Lincoln County Primary Care Center Inc | Pharmacy | 471 Main St, Madison, WV 25130-1223 | 2019-01-02 |
| 1376895995 | Lincoln County Primary Care Center Inc | Pharmacy | 1563 Sand Plant Rd, South Charleston, WV 25309-6120 | 2012-10-05 |
| 1831163906 | Lincoln County Primary Care Center Inc | Pharmacy | 7400 Lynn Ave, Hamlin, WV 25523-1138 | 2006-02-15 |
| Street Address |
471 MAIN ST |
| City | MADISON |
| State | WV |
| Zip Code | 25130-1223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902863590 | Robert B Atkins | Family Medicine | 471 Main St, Madison, WV 25130-1223 | 2006-04-27 |
| 1235699703 | Polly Nicole Anderson | Pharmacist | 471 Main St, Madison, WV 25130-1223 | 2019-03-21 |
| 1790257798 | Lincoln County Primary Care Center Inc | Pharmacy | 471 Main St, Madison, WV 25130-1223 | 2019-01-02 |
| 1699024232 | Cody S Coffman | Pharmacist | 471 Main St, Madison, WV 25130-1223 | 2012-08-29 |
| 1841476231 | Nicholas Lee Smith | Physician Assistant | 471 Main St, Madison, WV 25130-1223 | 2008-01-15 |
| 1639111768 | Jerry A. Quisenberry | Physician Assistant | 471 Main St, Madison, WV 25130-1223 | 2006-06-12 |
| 1932166063 | Ron D Stollings | Internal Medicine | 471 Main St, Madison, WV 25130-1223 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960957 | Sadie Vance | Technician | 1 Ave C, Madison, WV 25130 | 2020-07-30 |
| 1255940516 | Katie Adkins | Technician | 109 Ave C, Madison, WV 25130 | 2020-07-23 |
| 1386981488 | Integrated Health Care Providers, Inc. | Urology | 707 Madison Avenue, Madison, WV 25130 | 2013-01-09 |
| 1386710028 | Lisa Gaye Dolan | Registered Nurse | 69 Avenue B, Boone County of Educations, Madison, WV 25130 | 2006-11-27 |
| 1679671549 | Atkins Dds Inc | Dentist | 221 State Street, Suite 102, Madison, WV 25130 | 2006-09-21 |
| 1063446854 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 3265 Smoot Avenue, Madison, WV 25130 | 2006-07-10 |
| 1558318832 | Sriramloo Kesari | General Practice | 173 State St, Madison, WV 25130 | 2006-05-30 |
| 1689628489 | Kathy Jo Hill | Nurse Practitioner | 701 Madison Avenue, Boone Memorial Hospital, Madison, WV 25130 | 2006-05-19 |
| 1578513032 | Boone Memorial Hospital Inc | Clinic/Center | 697 Madison Avenue, Madison, WV 25130 | 2006-05-12 |
| 1770979874 | Michael Vaughn Baxter Bledsoe | Family Medicine | 701 Madison Ave, Madison, WV 25130 | 2015-04-15 |
| Find all providers in zip 25130 | ||||
| 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 |
|---|---|---|---|---|
| 1669024469 | Womencare Inc | Clinic/Center | 150 Josephine Ave, Madison, WV 25130-1357 | 2019-07-11 |
| 1225552342 | Flint Hills Community Health Center, Inc | Clinic/Center | 1500 Sw Boulevard, Madison, KS 66860-8054 | 2017-07-31 |
| 1932752888 | Midtown Health Center, Inc. | Clinic/Center | 700 S Kent St, Madison, NE 68748-6279 | 2019-07-19 |
| 1144637109 | North Florida Medical Centers Inc | Clinic/Center | 235 Sw Dade St, Suite A, Madison, FL 32340-2363 | 2014-07-22 |
| 1285872358 | Access Community Health Centers, Inc. | Clinic/Center | 2901 W Beltline Hwy, Suite 120, Madison, WI 53713-4226 | 2009-01-28 |
| 1740450089 | Womencare, Inc | Clinic/Center | 515 Main St, Madison, WV 25130-1417 | 2008-03-03 |
| 1669654307 | Access Community Health Centers, Inc. | Clinic/Center | 1102 S Park St, Madison, WI 53715-1714 | 2007-12-05 |
| 1760661714 | United Neighborhood Health Services, Inc | Clinic/Center | 601 W Due West Ave, Madison, TN 37115 | 2007-10-26 |
| 1568675858 | Access Community Health Centers, Inc. | Clinic/Center | 2202 S Park St, Madison, WI 53713-1916 | 2007-05-07 |
| 1417055617 | Access Community Health Centers, Inc. | Clinic/Center | 3434 E Washington Ave, Madison, WI 53704-4155 | 2006-09-20 |
| Find all providers in MADISON | ||||
Please comment or provide details below to improve the information on LINCOLN COUNTY PRIMARY CARE 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.