| Neurology & Headache Clinic Pllc | |
|
3100 Maccorkle Ave Se Suite 802 Charleston WV 25304 | |
| (304) 343-4400 | |
| (304) 345-5005 |
| Full Name | Neurology & Headache Clinic Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3100 Maccorkle Ave Se, Charleston, West Virginia |
| Authorized Official Name and Position | Darshankumar Ashwinbhai Dave (OWNER) |
| Authorized Official Contact | 3043434400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology & Headache Clinic Pllc 3100 Maccorkle Ave Se Ste 411 Charleston WV 25304-1230 Ph: (304) 343-4400 | Neurology & Headache Clinic Pllc 3100 Maccorkle Ave Se Suite 802 Charleston WV 25304 Ph: (304) 343-4400 |
| NPI Number | 1336185164 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 01/26/2018 |
| Medicare PECOS PAC ID | 4688715451 |
|---|---|
| Medicare Enrollment ID | O20091231000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336185164 | NPI | - | NPPES |
| 1841796000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 21117 (West Virginia) | Primary |
| Provider Name | Darshankumar A Dave |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033155437 PECOS PAC ID: 0446159651 Enrollment ID: I20040107000532 |
| Provider Name | Holly R Mckneely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588948962 PECOS PAC ID: 0547436156 Enrollment ID: I20120103000782 |
| Provider Name | Kassie J. Cosgrove Latimer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598115974 PECOS PAC ID: 0547556532 Enrollment ID: I20160830002665 |
| Provider Name | Celeste Kathryn Goodnight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831612977 PECOS PAC ID: 3476819400 Enrollment ID: I20171108001105 |
| Provider Name | Erica Ashleigh Hanshew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891225389 PECOS PAC ID: 4284990979 Enrollment ID: I20171114000245 |
| Provider Name | Deanna M Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568957215 PECOS PAC ID: 2365792926 Enrollment ID: I20180904000666 |
| Provider Name | Jennifer Terrice Classen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205484003 PECOS PAC ID: 9032441811 Enrollment ID: I20191028002672 |
| Provider Name | Rachel Denea Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336788546 PECOS PAC ID: 1456788819 Enrollment ID: I20200224002256 |
| Provider Name | Tracey Lynn Judy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770171225 PECOS PAC ID: 4385050962 Enrollment ID: I20210305000530 |
| Provider Name | Caren Renee Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972263242 PECOS PAC ID: 8325431554 Enrollment ID: I20220210000254 |
| Provider Name | Mandy Sangani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972259075 PECOS PAC ID: 5799171922 Enrollment ID: I20220414002534 |
| Provider Name | Lyndsie Rae Wriston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992429484 PECOS PAC ID: 5597134239 Enrollment ID: I20221220000382 |
| Provider Name | Ashley Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265121891 PECOS PAC ID: 5698126324 Enrollment ID: I20240108000864 |
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