| Timothy Maynard, | |
|
402 C Street, Ceredo, WV 25507 | |
| (304) 908-1204 | |
| (304) 908-1224 |
| Full Name | Timothy Maynard |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 12 Years |
| Location | 402 C Street, Ceredo, West Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942618657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 3008802 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Stonerise At Home | Barboursville, WV | Home health agency |
| Stonerise At Home | South charleston, WV | Home health agency |
| King's Daughters' Med. Ctr. Hha | Ashland, KY | Home health agency |
| Hospice Of Huntington | Huntington, WV | Hospice |
| St Mary's Medical Center | Huntington, WV | Hospital |
| Charleston Area Medical Center | Charleston, WV | Hospital |
| King's Daughters' Medical Center | Ashland, KY | Hospital |
| North Carolina Baptist Hospital | Winston-salem, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oncall Health And Aesthetic Care | 9638472525 | 10 |
| Entity Name | Oncall Health And Aesthetic Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679944383 PECOS PAC ID: 9638472525 Enrollment ID: O20160127001411 |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Maynard, Po Box 1251, Ceredo, WV 25507-1251 Ph: (304) 908-1204 | Timothy Maynard, 402 C Street, Ceredo, WV 25507 Ph: (304) 908-1204 |
Jodi Silva-dutey, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 402 C Street, Ceredo, WV 25507 Phone: 304-908-1204 Fax: 304-908-1224 |