COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1912932526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912932526 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Other Organization Name | TRICOUNTY HEALTH CLINIC |
| Practice Address |
78 Queens Alley Rd Rock Cave WV 26234-5890 |
| Mailing Address |
Po Box 217 Rock Cave WV 26234-0217 |
| Practice Telephone | 3049246262 |
| Practice Fax Number | 3049245460 |
| Mailing Telephone | 3049246262 |
| Mailing Fax Number | 3049245460 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 3073177275 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | MS BCBS | 001709743 | 01 |
| WV | RR MEDICARE | CL3758 | 01 |
| WV | 1912932526 | 05 |
| Other Name | Type Code |
|---|---|
| TriCounty Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 1538711452 | Community Care of West Virginia, Inc. | Clinic/Center | 481 Heavner Grove Rd, Buckhannon, WV 26201-4859 | 2019-07-11 |
| 1710539630 | Community Care of West Virginia, Inc. | Clinic/Center | 5078 Tallmansville Rd, Buckhannon, WV 26201-1687 | 2019-07-11 |
| 1871003178 | Community Care of West Virginia, Inc. | Clinic/Center | 228 Kanawha Avenue, Burnsville, WV 26335 | 2017-10-02 |
| 1053821363 | Community Care of West Virginia, Inc. | Clinic/Center | 55 Little Birch Rd, Sutton, WV 26601-9469 | 2017-10-02 |
| 1609386978 | Community Care of West Virginia, Inc. | Clinic/Center | 15300 Us Highway 33 W, Linn, WV 26384-9322 | 2017-10-02 |
| 1962912261 | Community Care of West Virginia, Inc. | Clinic/Center | 142 Flatwoods Corner Road, Flatwoods, WV 26621 | 2017-10-02 |
| 1811366248 | Community Care of West Virginia, Inc. | Clinic/Center | 501 Bomont Rd, Bomont, WV 25030-9666 | 2015-09-16 |
| 1043686553 | Community Care of West Virginia, Inc. | Clinic/Center | 358 Court Ave, Weston, WV 26452-2008 | 2015-08-19 |
| Street Address |
78 QUEENS ALLEY RD |
| City | ROCK CAVE |
| State | WV |
| Zip Code | 26234-5890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891154951 | Cristy Dawn Carpenter | Nurse Practitioner | 78 Queens Alley Rd, Rock Cave, WV 26234-5890 | 2016-02-17 |
| 1285070714 | Ja'me Ann Brandish | Psychologist | 78 Queens Alley Rd, Rock Cave, WV 26234-5890 | 2013-05-10 |
| 1841586492 | Jenna Irene Ward | Physician Assistant | 78 Queens Alley Rd, Rock Cave, WV 26234-5890 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828757 | Banks District Volunteer Fire Department Inc | Ambulance | 260 Rock Cave Rd, Rock Cave, WV 26234 | 2020-10-15 |
| 1861577090 | Tri County Health Clinic Inc | Pharmacy | 123 Queens Ally Road, Rock Cave, WV 26234 | 2006-10-26 |
| 1508890351 | Total Life Clinicians, LLC | Clinic/Center | Rt 4 & 20 South, 2nd Floor, Rock Cave, WV 26234 | 2006-07-10 |
| 1528008760 | Patricia L Collett | Physician Assistant | Rt. 4 & 20 S Intersection, Rock Cave, WV 26234 | 2006-06-07 |
| 1699752147 | Cynthia Robin Chapman | Physician Assistant | Route 4 & 20 Intersection South, Rock Cave, WV 26234 | 2005-12-27 |
| 1740263151 | Debra Marie Auble | Family Medicine | Rt. 4 & 20 South, Rock Cave, WV 26234 | 2005-11-21 |
| 1821082793 | David W Plank | Physician Assistant | Route 4 & 20 S. Intersection, Rock Cave, WV 26234 | 2005-09-07 |
| 1831531904 | Letitia Jean Golden | Nurse Practitioner | Route 4 & 20 S. Intersection, Rock Cave, WV 26234 | 2013-07-18 |
| 1033460050 | Stacy C Miller | Physician Assistant | Route 4 & 20 S. Intersection, Rock Cave, WV 26234 | 2012-10-01 |
| 1861708513 | Genevieve F Larimer | Nurse Practitioner | Route 4 & 20 S. Intersection, Rock Cave, WV 26234 | 2010-08-19 |
| Find all providers in zip 26234 | ||||
| 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 |
|---|---|---|---|---|
| 1801493499 | Camden On Gauley Medical Center Inc | Clinic/Center | 52 Florence Street, Ansted, WV 25812 | 2020-10-06 |
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 1619503422 | Change Inc | Clinic/Center | 114 Taylor Ave, Weirton, WV 26062-4635 | 2020-03-13 |
| 1861023699 | Logan-mingo Area Mental Health, Inc | Clinic/Center | 2954 Buffalo Creek Road, Chattaroy, WV 25667 | 2020-01-30 |
| 1689220402 | New River Health Association, Inc. | Clinic/Center | 2 Greyhound Ln., Smithers, WV 25186 | 2019-08-16 |
| 1740836873 | Williamson Health & Wellness Center Inc | Clinic/Center | 5 Parkway Dr, Williamson, WV 25661-3428 | 2019-08-14 |
| 1699321729 | Williamson Health & Wellness Center Inc | Clinic/Center | 50 Panther Blvd, Williamson, WV 25661-7441 | 2019-08-14 |
| 1083260129 | Williamson Health & Wellness Center Inc | Clinic/Center | 300 Blue Devil Lane, Kermit, WV 25661 | 2019-08-14 |
| 1225684731 | Williamson Health & Wellness Center Inc | Clinic/Center | 1000 King Coal Hwy, Delbarton, WV 25670-9529 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COMMUNITY CARE OF WEST VIRGINIA, 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.