| West | |
|
119 Chestnut Dr High Point NC 27262-6803 | |
| (336) 882-2125 | |
| (336) 882-8153 |
| Full Name | West |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 119 Chestnut Dr, High Point, North Carolina |
| Authorized Official Name and Position | Ronald C. Rau (PRESIDENT) |
| Authorized Official Contact | 3368822125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West 301 E Washington St Suite 101 Greensboro NC 27401-2993 Ph: (336) 333-6860 | West 119 Chestnut Dr High Point NC 27262-6803 Ph: (336) 882-2125 |
| NPI Number | 1124166350 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 03/01/2012 |
| Medicare PECOS PAC ID | 2860655735 |
|---|---|
| Medicare Enrollment ID | O20120514000362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124166350 | NPI | - | NPPES |
| 8301008B | Medicaid | NC | |
| 8301008 | Medicaid | NC | |
| 6005602 | Medicaid | NC | |
| 8301008G | Medicaid | NC | |
| 8301008T | Medicaid | NC | |
| 8301008Q | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-041-010 (North Carolina) | Primary |
| Provider Name | Keshavpal Gunna Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942269766 PECOS PAC ID: 5092757617 Enrollment ID: I20050524001072 |
| Provider Name | Anthony Tunelle Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558357160 PECOS PAC ID: 4587827456 Enrollment ID: I20120514000402 |
| Provider Name | Christine E Kerr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215216205 PECOS PAC ID: 4486813615 Enrollment ID: I20160920002374 |
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