| St. Mary's Medical Management, Llc | |
|
2900 1st Ave Huntington WV 25702 | |
| (304) 526-1234 | |
| (304) 526-1489 |
| Full Name | St. Mary's Medical Management, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2900 1st Ave, Huntington, West Virginia |
| Authorized Official Name and Position | Todd Campbell (CFO) |
| Authorized Official Contact | 3045268914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary's Medical Management, Llc Po Box 4190 Barboursville WV 25504-4190 Ph: (304) 908-9201 | St. Mary's Medical Management, Llc 2900 1st Ave Huntington WV 25702 Ph: (304) 526-1234 |
| NPI Number | 1922155217 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/13/2025 |
| Certification Date | 08/13/2025 |
| Medicare PECOS PAC ID | 5890897151 |
|---|---|
| Medicare Enrollment ID | O20070216000690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922155217 | NPI | - | NPPES |
| 001934200 | Other | WV | BSMT MOUNTAIN STATE |
| 3810007944 | Medicaid | WV | |
| 3810009673 | Other | WV | UNISYS / ST MARY'S LAB |
| 7100073660 | Medicaid | KY | |
| 002016965 | Other | WV | BSMT/ MID LEVEL |
| 7100101210 | Medicaid | KY |
| Provider Name | Timothy G Saxe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174520282 PECOS PAC ID: 4789583501 Enrollment ID: I20040106000639 |
| Provider Name | Esam Nuri Baryun |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1962504829 PECOS PAC ID: 8820081482 Enrollment ID: I20040407001458 |
| Provider Name | Albert Jeffrey Kaplan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184664518 PECOS PAC ID: 9032190699 Enrollment ID: I20040528000417 |
| Provider Name | Stanley Zaslau |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1821183278 PECOS PAC ID: 3173593100 Enrollment ID: I20040728000477 |
| Provider Name | David M Life |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467416875 PECOS PAC ID: 2769453703 Enrollment ID: I20040804000090 |
| Provider Name | Amber Kuhl |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679571905 PECOS PAC ID: 2062489321 Enrollment ID: I20040915000724 |
| Provider Name | Syam B Stoll |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346214913 PECOS PAC ID: 3375504657 Enrollment ID: I20041020000683 |
| Provider Name | Susan C King-watts |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1639154172 PECOS PAC ID: 6800846130 Enrollment ID: I20050125000626 |
| Provider Name | Mark Mcdaniel |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1134230311 PECOS PAC ID: 2961441605 Enrollment ID: I20050502000765 |
| Provider Name | Aynessa Dianne Mondlak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407977192 PECOS PAC ID: 9638104714 Enrollment ID: I20050927001529 |
| Provider Name | Kathy Lynn Saber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194724534 PECOS PAC ID: 5698794832 Enrollment ID: I20051117000298 |
| Provider Name | Gary David Cremeans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821058439 PECOS PAC ID: 3779505110 Enrollment ID: I20051228000479 |
| Provider Name | Thomas C Rushton |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740245018 PECOS PAC ID: 6709808918 Enrollment ID: I20051230000262 |
| Provider Name | Sandra K Ooten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942268933 PECOS PAC ID: 7618906256 Enrollment ID: I20060710000305 |
| Provider Name | Benjamin Allan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396781670 PECOS PAC ID: 5496768764 Enrollment ID: I20060803000367 |
| Provider Name | Mark J Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003831017 PECOS PAC ID: 4688678907 Enrollment ID: I20060829000258 |
| Provider Name | Rachel A Conrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043234156 PECOS PAC ID: 0244333268 Enrollment ID: I20070313000299 |
| Provider Name | Vivekanand Shankar Neginhal |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578635074 PECOS PAC ID: 9032212527 Enrollment ID: I20070322000058 |
| Provider Name | Kevin D Brown |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811968555 PECOS PAC ID: 8426086745 Enrollment ID: I20070607000429 |
| Provider Name | Steven S Brumfield |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992745624 PECOS PAC ID: 5193818615 Enrollment ID: I20070829000532 |
| Provider Name | Ahmad R Nusair |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689644676 PECOS PAC ID: 2264446152 Enrollment ID: I20071009000570 |
| Provider Name | Nepal Chowdhury |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1114006574 PECOS PAC ID: 9133172976 Enrollment ID: I20071213000082 |
| Provider Name | Lisa M Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124201165 PECOS PAC ID: 4183707771 Enrollment ID: I20080205000508 |
| Provider Name | Carl Frederick Mccomas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639238728 PECOS PAC ID: 4183622384 Enrollment ID: I20080326000012 |
| Provider Name | Luis E Bolano |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134186836 PECOS PAC ID: 4688777451 Enrollment ID: I20080415000113 |
| Provider Name | Steven C Lochow |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538187364 PECOS PAC ID: 3678674009 Enrollment ID: I20080602000114 |
| Provider Name | Erick James Willis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912111097 PECOS PAC ID: 0143397604 Enrollment ID: I20080924000778 |
| Provider Name | Frederick Carl Martinez |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497849483 PECOS PAC ID: 7416004106 Enrollment ID: I20090415000592 |
| Provider Name | Lou B Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457530289 PECOS PAC ID: 4284789066 Enrollment ID: I20090831000259 |
| Provider Name | Lisa Carol Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437382595 PECOS PAC ID: 8426197518 Enrollment ID: I20091203000021 |
| Provider Name | Matthew C Werthammer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1912133570 PECOS PAC ID: 8224178991 Enrollment ID: I20091211000073 |
| Provider Name | Panayotis Ignatiadis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1972697969 PECOS PAC ID: 0042278681 Enrollment ID: I20100212000721 |
| Provider Name | Rocco A Morabito |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447255906 PECOS PAC ID: 0648374702 Enrollment ID: I20100901000009 |
| Provider Name | Nestor Dans |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588652192 PECOS PAC ID: 2961315999 Enrollment ID: I20100913000249 |
| Provider Name | Allan Scott Chamberlain |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508864281 PECOS PAC ID: 2062489339 Enrollment ID: I20101103000693 |
| Provider Name | Mauricio Saleme |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841395282 PECOS PAC ID: 6901095975 Enrollment ID: I20110106000123 |
| Provider Name | Charles Kevin Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447227285 PECOS PAC ID: 2264452648 Enrollment ID: I20110127001211 |
| Provider Name | Eric Lee Ping |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003832973 PECOS PAC ID: 5395728489 Enrollment ID: I20110207000219 |
| Provider Name | Rocco Morabito |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366649642 PECOS PAC ID: 7618147182 Enrollment ID: I20110822000002 |
| Provider Name | Aamir Cheema |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154388254 PECOS PAC ID: 3173544129 Enrollment ID: I20110826000433 |
| Provider Name | Jaime L Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790068534 PECOS PAC ID: 9436321544 Enrollment ID: I20111015000034 |
| Provider Name | Sharon K Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700167558 PECOS PAC ID: 6204003171 Enrollment ID: I20120117000540 |
| Provider Name | Tarun Popli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376776443 PECOS PAC ID: 2163670035 Enrollment ID: I20120918000735 |
| Provider Name | Laura E Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801148838 PECOS PAC ID: 8527210640 Enrollment ID: I20121218000090 |
| Provider Name | Christi Dawn Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851637219 PECOS PAC ID: 8022262203 Enrollment ID: I20130218000327 |
| Provider Name | Daniel L Vanhoose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285921312 PECOS PAC ID: 3476724345 Enrollment ID: I20131104000267 |
| Provider Name | Amber N Egan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043647779 PECOS PAC ID: 9133356454 Enrollment ID: I20131212000597 |
| Provider Name | Kara Willenburg |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972705150 PECOS PAC ID: 7012053861 Enrollment ID: I20140321001642 |
| Provider Name | Heather Leigh Mayville |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1699190181 PECOS PAC ID: 0244463610 Enrollment ID: I20140509001121 |
| Provider Name | Dwight Saulle |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215195615 PECOS PAC ID: 0840427084 Enrollment ID: I20140903001167 |
| Provider Name | Andrea M Lauffer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114247475 PECOS PAC ID: 1951548254 Enrollment ID: I20140905001185 |
| Provider Name | Stacey N Hensel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801043633 PECOS PAC ID: 6406075894 Enrollment ID: I20140917001491 |
| Provider Name | Roderick A Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235295072 PECOS PAC ID: 0840514881 Enrollment ID: I20150121001717 |
| Provider Name | Clifton Robert Bolinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538456892 PECOS PAC ID: 6901054824 Enrollment ID: I20150206001425 |
| Provider Name | Rudy M Malayil |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1114151347 PECOS PAC ID: 8325266760 Enrollment ID: I20150223000681 |
| Provider Name | Anton E Coleman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740263227 PECOS PAC ID: 9032196035 Enrollment ID: I20150828000089 |
| Provider Name | Robin Nicole Tolbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033477088 PECOS PAC ID: 2365681756 Enrollment ID: I20150902001982 |
| Provider Name | Lori Lynn Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720429806 PECOS PAC ID: 1355650003 Enrollment ID: I20151019002441 |
| Provider Name | Kelly L Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508248436 PECOS PAC ID: 3476862855 Enrollment ID: I20151026002284 |
| Provider Name | Andy D Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972964211 PECOS PAC ID: 1557654886 Enrollment ID: I20160725002474 |
| Provider Name | Shannon Bartoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992150452 PECOS PAC ID: 0547558710 Enrollment ID: I20161004002627 |
| Provider Name | Mica Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760833966 PECOS PAC ID: 1153619432 Enrollment ID: I20161019002789 |
| Provider Name | Andrew Christopher |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1932499563 PECOS PAC ID: 8729389853 Enrollment ID: I20161116001717 |
| Provider Name | Margaret J Vereb |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265494215 PECOS PAC ID: 0244210565 Enrollment ID: I20161221000502 |
| Provider Name | Katherine Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952858011 PECOS PAC ID: 3577845569 Enrollment ID: I20170127000649 |
| Provider Name | Maegen L Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255881165 PECOS PAC ID: 3173806940 Enrollment ID: I20170202000918 |
| Provider Name | Chelsey Rae Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578974242 PECOS PAC ID: 3173747458 Enrollment ID: I20170814002721 |
| Provider Name | Caleb R Huff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538505359 PECOS PAC ID: 6507006418 Enrollment ID: I20170825002943 |
| Provider Name | Elie Khalil |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1578801056 PECOS PAC ID: 9032481924 Enrollment ID: I20170828003289 |
| Provider Name | Amanda R Kinnard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588104327 PECOS PAC ID: 3072886118 Enrollment ID: I20170912000631 |
| Provider Name | Sirisha Pasham Reddy |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1710080130 PECOS PAC ID: 7911008297 Enrollment ID: I20171010000373 |
| Provider Name | Ghassan Toufic Moufarrege |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1225047749 PECOS PAC ID: 7618234584 Enrollment ID: I20171130002389 |
| Provider Name | Peimei He |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1508129719 PECOS PAC ID: 9537474788 Enrollment ID: I20180111000849 |
| Provider Name | Frank Duncan Scott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508804733 PECOS PAC ID: 6507879640 Enrollment ID: I20180129002175 |
| Provider Name | Melissa Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891205167 PECOS PAC ID: 5294095790 Enrollment ID: I20180131003234 |
| Provider Name | Richard J Heuer |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1497757439 PECOS PAC ID: 1850204520 Enrollment ID: I20180409000047 |
| Provider Name | Crystal Lynn Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306355912 PECOS PAC ID: 4284993841 Enrollment ID: I20180516002083 |
| Provider Name | Melissa Sue Emery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700275260 PECOS PAC ID: 3274858600 Enrollment ID: I20180716000147 |
| Provider Name | Jaschar Shakuri-rad |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1376982652 PECOS PAC ID: 1557504438 Enrollment ID: I20180820000211 |
| Provider Name | Deanna Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568957215 PECOS PAC ID: 2365792926 Enrollment ID: I20180904000666 |
| Provider Name | Emily Gatrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790263010 PECOS PAC ID: 8325399793 Enrollment ID: I20180924003069 |
| Provider Name | Karim W Boukhemis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750677795 PECOS PAC ID: 0648572438 Enrollment ID: I20181008003492 |
| Provider Name | Staci Johnson Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467947895 PECOS PAC ID: 3678826617 Enrollment ID: I20181022001769 |
| Provider Name | April Beth Blair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750852364 PECOS PAC ID: 3072850106 Enrollment ID: I20190129000247 |
| Provider Name | Cathy L Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306316468 PECOS PAC ID: 0345581138 Enrollment ID: I20190403003162 |
| Provider Name | Jason M Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962065243 PECOS PAC ID: 3870836455 Enrollment ID: I20190522002775 |
| Provider Name | Heather Jasmine Holton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063076388 PECOS PAC ID: 9032452412 Enrollment ID: I20190529000459 |
| Provider Name | Andrew M Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609430172 PECOS PAC ID: 5395088603 Enrollment ID: I20190529002317 |
| Provider Name | Jessica Paige Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306302468 PECOS PAC ID: 7719211135 Enrollment ID: I20190618003530 |
| Provider Name | Jamie Brumfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760046387 PECOS PAC ID: 9133457740 Enrollment ID: I20190821000316 |
| Provider Name | Kimberly D Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871148130 PECOS PAC ID: 2062742877 Enrollment ID: I20190920002492 |
| Provider Name | Eric J Sacknoff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295734598 PECOS PAC ID: 3072547355 Enrollment ID: I20191104000028 |
| Provider Name | Lora Courts-midkiff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760033518 PECOS PAC ID: 6800128216 Enrollment ID: I20191104001203 |
| Provider Name | Mark A Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104473982 PECOS PAC ID: 5496187429 Enrollment ID: I20191113002161 |
| Provider Name | Bethany K Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073161683 PECOS PAC ID: 1254763931 Enrollment ID: I20191119000328 |
| Provider Name | Alicia J Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578110672 PECOS PAC ID: 0840622536 Enrollment ID: I20191119000591 |
| Provider Name | William Boysen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912346503 PECOS PAC ID: 8527361328 Enrollment ID: I20200115001988 |
| Provider Name | Betty J Waddell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235779802 PECOS PAC ID: 4688001449 Enrollment ID: I20200218000294 |
| Provider Name | Richard B Fenney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689204539 PECOS PAC ID: 0042647174 Enrollment ID: I20200302000001 |
| Provider Name | Hollie Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073153912 PECOS PAC ID: 2466880695 Enrollment ID: I20200320002562 |
| Provider Name | Stephanie N Kingman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477191476 PECOS PAC ID: 2567891336 Enrollment ID: I20200330001643 |
| Provider Name | Onyechi Megafu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043690712 PECOS PAC ID: 0840622809 Enrollment ID: I20200622000073 |
| Provider Name | Audrey Ann Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134745409 PECOS PAC ID: 9537582226 Enrollment ID: I20200714002237 |
| Provider Name | Taucha Lynn Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790300366 PECOS PAC ID: 7315363264 Enrollment ID: I20200821002612 |
| Provider Name | Hesham Mohammed Mubarak Awadh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912381922 PECOS PAC ID: 4789991910 Enrollment ID: I20200909001419 |
| Provider Name | Anthony Dempsey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417120072 PECOS PAC ID: 2860671914 Enrollment ID: I20200929002937 |
| Provider Name | Abhinav Khanna |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1154734127 PECOS PAC ID: 2860794286 Enrollment ID: I20201012001854 |
| Provider Name | Jason H Malenfant |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1578976411 PECOS PAC ID: 4789936808 Enrollment ID: I20210120002447 |
| Provider Name | Tessa I Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154911006 PECOS PAC ID: 5496169302 Enrollment ID: I20210203002240 |
| Provider Name | Nathan Kyle Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609461805 PECOS PAC ID: 5698182590 Enrollment ID: I20210319001708 |
| Provider Name | Cynthia Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093203903 PECOS PAC ID: 8426458670 Enrollment ID: I20210610000535 |
| Provider Name | Roger D Robertson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275823544 PECOS PAC ID: 1557660248 Enrollment ID: I20210629000463 |
| Provider Name | Jarrod Russell Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396057527 PECOS PAC ID: 0840436523 Enrollment ID: I20210726001625 |
| Provider Name | Marlee C Layh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225656044 PECOS PAC ID: 3577969476 Enrollment ID: I20210901000344 |
| Provider Name | Lori Ann Ervin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255841797 PECOS PAC ID: 3274892690 Enrollment ID: I20210921000552 |
| Provider Name | Britni Courts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881356806 PECOS PAC ID: 5395143614 Enrollment ID: I20211018000446 |
| Provider Name | Jessica Clarkson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326551029 PECOS PAC ID: 3870992043 Enrollment ID: I20211115001173 |
| Provider Name | Ashley Nicole Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881352342 PECOS PAC ID: 0941692263 Enrollment ID: I20220119000863 |
| Provider Name | Rebecca Ann Fraley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346999695 PECOS PAC ID: 9638565203 Enrollment ID: I20220407000506 |
| Provider Name | Heather Lee Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861147209 PECOS PAC ID: 8820484157 Enrollment ID: I20220413000580 |
| Provider Name | Jennifer Michelle Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437899622 PECOS PAC ID: 8820473804 Enrollment ID: I20220912001165 |
| Provider Name | Kaylie Noelle Tomlinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174255434 PECOS PAC ID: 0749666428 Enrollment ID: I20221004000532 |
| Provider Name | Susan Rene Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831551688 PECOS PAC ID: 9739469115 Enrollment ID: I20221005000301 |
| Provider Name | Amanda Gayle Fei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245969930 PECOS PAC ID: 3870961279 Enrollment ID: I20221116000193 |
| Provider Name | Katrina Lynn Cremeans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578282745 PECOS PAC ID: 2365810637 Enrollment ID: I20221117000020 |
| Provider Name | Courtney B Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679208656 PECOS PAC ID: 5092183673 Enrollment ID: I20221202000403 |
| Provider Name | Kayla Kristine Meade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548972508 PECOS PAC ID: 0840662300 Enrollment ID: I20230209000571 |
| Provider Name | Lindsay Ruth Gotham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013631100 PECOS PAC ID: 3173998069 Enrollment ID: I20230406000809 |
| Provider Name | John Scott Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689371072 PECOS PAC ID: 1254796394 Enrollment ID: I20230425002428 |
| Provider Name | Jennifer Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740987189 PECOS PAC ID: 2668837428 Enrollment ID: I20230501000141 |
| Provider Name | Aimee Nicole Merritt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497451264 PECOS PAC ID: 7810205929 Enrollment ID: I20230501002419 |
| Provider Name | Danielle Alexandra Justice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912603937 PECOS PAC ID: 8820453467 Enrollment ID: I20230503001880 |
| Provider Name | Brittany Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174211783 PECOS PAC ID: 2860853090 Enrollment ID: I20230803001720 |
| Provider Name | Juan Guillermo Bastidas |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1033301080 PECOS PAC ID: 7315008950 Enrollment ID: I20230828002526 |
| Provider Name | Amber Jude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356113658 PECOS PAC ID: 2961852892 Enrollment ID: I20231219001239 |
| Provider Name | Mackenzie Brooke Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407621543 PECOS PAC ID: 9830540350 Enrollment ID: I20240109004422 |
| Provider Name | Yvonne F Sturgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811779200 PECOS PAC ID: 7012352834 Enrollment ID: I20240301002850 |
| Provider Name | Timothy R Yoost |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245328012 PECOS PAC ID: 3779613666 Enrollment ID: I20240306002402 |
| Provider Name | David Weintraub |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1417191750 PECOS PAC ID: 7113213463 Enrollment ID: I20240322003910 |
| Provider Name | Matthew Aaron Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033897368 PECOS PAC ID: 2769829878 Enrollment ID: I20240326000143 |
| Provider Name | Denise Christel Gregg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831975762 PECOS PAC ID: 9931549722 Enrollment ID: I20240426001391 |
| Provider Name | Muhammad Muslim Maaz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295230381 PECOS PAC ID: 1850838392 Enrollment ID: I20240801004360 |
| Provider Name | Michelle Dillow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871013995 PECOS PAC ID: 9638440340 Enrollment ID: I20240821003547 |
| Provider Name | Kofi Marfo Osei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124469317 PECOS PAC ID: 2961799820 Enrollment ID: I20240924003263 |
| Provider Name | Lauren Inners Logan |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1851702716 PECOS PAC ID: 4981821246 Enrollment ID: I20241104000708 |
| Provider Name | Moses Adedamola Adebayo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568995413 PECOS PAC ID: 7315224698 Enrollment ID: I20241221000096 |
| Provider Name | Heather Jan Matthies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457794646 PECOS PAC ID: 4880834472 Enrollment ID: I20250108000265 |
| Provider Name | Morgan Elizabeth Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679390991 PECOS PAC ID: 5092243576 Enrollment ID: I20250111000247 |
Graceway Counseling Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 744 4th Ave Ste 2, Huntington, WV 25701 Phone: 304-691-0873 Fax: 304-955-9057 | |
Patchwork Therapy And Growth Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4766 Us Route 60 Unit B, Huntington, WV 25705 Phone: 304-802-4769 Fax: 304-318-7183 | |
Prestera Center For Mental Health Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3375 Us Route 60, Huntington, WV 25705 Phone: 304-525-7851 Fax: 304-697-1286 | |
Huntington Mental Health Associates, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 6th Ave, Huntington, WV 25701 Phone: 304-523-1142 | |
Starlight Behavioral Health Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5315 Cherry Lawn Rd, Huntington, WV 25705 Phone: 304-302-2078 Fax: 304-302-0279 | |
Ncgcare Acquisition, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5317 Cherry Lawn Rd, Huntington, WV 25705 Phone: 304-302-2078 Fax: 304-302-7260 | |
Goodwill Industries Of Kyowva Area, Inc. Family Service Division Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1102 Memorial Blvd. W, Huntington, WV 25701 Phone: 304-523-9545 Fax: 304-525-7038 |