| Boone Memorial Hospital | |
|
701 Madison Ave Madison WV 25130-1669 | |
| (304) 369-1230 | |
| (304) 369-6036 |
| Full Name | Boone Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 Madison Ave, Madison, West Virginia |
| Authorized Official Name and Position | Virgil Underwood (CEO) |
| Authorized Official Contact | 3043691230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boone Memorial Hospital 701 Madison Ave Madison WV 25130-1669 Ph: (304) 369-1230 | Boone Memorial Hospital 701 Madison Ave Madison WV 25130-1669 Ph: (304) 369-1230 |
| NPI Number | 1285686725 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 3375433352 |
|---|---|
| Medicare Enrollment ID | O20051111000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285686725 | NPI | - | NPPES |
| 0007462000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 119 (West Virginia) | Primary |
| Provider Name | Melissa D White |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700890407 PECOS PAC ID: 7618873084 Enrollment ID: I20031208001072 |
| Provider Name | Mohamad B Haffar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205995701 PECOS PAC ID: 8426951492 Enrollment ID: I20040129000524 |
| Provider Name | William D Trusnovic |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407105695 PECOS PAC ID: 0042203382 Enrollment ID: I20040405000496 |
| Provider Name | Charles D Crigger |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386640662 PECOS PAC ID: 7113917154 Enrollment ID: I20040514000893 |
| Provider Name | Angelia D Slack |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164497178 PECOS PAC ID: 9739080110 Enrollment ID: I20040526000847 |
| Provider Name | Frank Charles Lucente |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306932140 PECOS PAC ID: 0648259697 Enrollment ID: I20040714001319 |
| Provider Name | Katherine L Stamper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952324808 PECOS PAC ID: 2668440272 Enrollment ID: I20040921001382 |
| Provider Name | Kathy Jo Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689628489 PECOS PAC ID: 8022074897 Enrollment ID: I20041203000104 |
| Provider Name | Christopher P Flanagan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740224476 PECOS PAC ID: 9830129162 Enrollment ID: I20050817000055 |
| Provider Name | James R Long |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740223346 PECOS PAC ID: 0749210086 Enrollment ID: I20050817000134 |
| Provider Name | Larry Orval Lucas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831133552 PECOS PAC ID: 8325078561 Enrollment ID: I20050817000188 |
| Provider Name | Amy Parker Sayre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528025350 PECOS PAC ID: 6103807052 Enrollment ID: I20051107000491 |
| Provider Name | Melanie L Harper-allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710997671 PECOS PAC ID: 3072523935 Enrollment ID: I20060424000131 |
| Provider Name | Jaime Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710915574 PECOS PAC ID: 4385657816 Enrollment ID: I20060728000157 |
| Provider Name | Blitz E Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326140252 PECOS PAC ID: 6002811411 Enrollment ID: I20060918000452 |
| Provider Name | Kenneth Chadwic Adkins |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1629176540 PECOS PAC ID: 8921004706 Enrollment ID: I20061018000698 |
| Provider Name | Ronald D Chattin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770597171 PECOS PAC ID: 3779584727 Enrollment ID: I20070118000288 |
| Provider Name | Ziad A Chanaa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720172760 PECOS PAC ID: 3375630551 Enrollment ID: I20071105000391 |
| Provider Name | James Stollings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699725168 PECOS PAC ID: 8426082199 Enrollment ID: I20071128000150 |
| Provider Name | Philip Todd Berry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194943522 PECOS PAC ID: 7416030093 Enrollment ID: I20080206000379 |
| Provider Name | Thomas B Cortellesi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588646459 PECOS PAC ID: 0749228195 Enrollment ID: I20080213000735 |
| Provider Name | Ryan Houston Fitzwater |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1770524977 PECOS PAC ID: 2769407683 Enrollment ID: I20090114000229 |
| Provider Name | Howard W Lafferty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508066648 PECOS PAC ID: 8729145891 Enrollment ID: I20090318000188 |
| Provider Name | Kimberly Mitchell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225275324 PECOS PAC ID: 9830246263 Enrollment ID: I20090421000758 |
| Provider Name | Deborah Renee Kirkendall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760614200 PECOS PAC ID: 7911044649 Enrollment ID: I20091028000543 |
| Provider Name | Nancy L Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902137177 PECOS PAC ID: 4082758941 Enrollment ID: I20100217000020 |
| Provider Name | Timothy Ray Deer |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1861424210 PECOS PAC ID: 7214822204 Enrollment ID: I20100219000513 |
| Provider Name | Casey Shaun Hager |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497918452 PECOS PAC ID: 1153453659 Enrollment ID: I20100720000140 |
| Provider Name | Kelly Ann Hager |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881852549 PECOS PAC ID: 3274690508 Enrollment ID: I20100907001097 |
| Provider Name | David S Mullett |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750582540 PECOS PAC ID: 4183817620 Enrollment ID: I20101018000269 |
| Provider Name | Irving V Westney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245211275 PECOS PAC ID: 9931188794 Enrollment ID: I20110228000936 |
| Provider Name | Leslie Michael Peterson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730341264 PECOS PAC ID: 6800078411 Enrollment ID: I20110302001062 |
| Provider Name | Michael Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588966030 PECOS PAC ID: 9638355977 Enrollment ID: I20110520000266 |
| Provider Name | Melissa Moody |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750505384 PECOS PAC ID: 1850560889 Enrollment ID: I20110809000525 |
| Provider Name | Hani Nazha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952501249 PECOS PAC ID: 0244486470 Enrollment ID: I20120803000435 |
| Provider Name | Richard W Knapp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134407018 PECOS PAC ID: 3870732530 Enrollment ID: I20130610000763 |
| Provider Name | Jamie L Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083056345 PECOS PAC ID: 7810129376 Enrollment ID: I20140415001817 |
| Provider Name | Andrew Bryant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194018093 PECOS PAC ID: 7113157637 Enrollment ID: I20140918001392 |
| Provider Name | Ashley Gunno Comer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306249966 PECOS PAC ID: 8123341369 Enrollment ID: I20141219001401 |
| Provider Name | Kelli Canterbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023427283 PECOS PAC ID: 9133443252 Enrollment ID: I20150121000395 |
| Provider Name | Deborah Townsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881079614 PECOS PAC ID: 3577872993 Enrollment ID: I20151026000048 |
| Provider Name | Ashton Michelle Holbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720430499 PECOS PAC ID: 9830485168 Enrollment ID: I20160913000015 |
| Provider Name | Tara L Tackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235585027 PECOS PAC ID: 0042507030 Enrollment ID: I20160919001756 |
| Provider Name | Angel D Glick |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1144377540 PECOS PAC ID: 7214216472 Enrollment ID: I20161114000281 |
| Provider Name | Susan Mullooly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740627363 PECOS PAC ID: 8426366691 Enrollment ID: I20170628002937 |
| Provider Name | Tammi E Blankenship |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477042943 PECOS PAC ID: 2769737279 Enrollment ID: I20180622002473 |
| Provider Name | Loretta Marie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326524422 PECOS PAC ID: 9436408184 Enrollment ID: I20180814002536 |
| Provider Name | Michael Vaughn Baxter Bledsoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770979874 PECOS PAC ID: 7810203163 Enrollment ID: I20180905001337 |
| Provider Name | Ali A Pitafi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023115615 PECOS PAC ID: 8921250044 Enrollment ID: I20181029001366 |
| Provider Name | Jalal U Akbar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720063795 PECOS PAC ID: 3971559626 Enrollment ID: I20181101002875 |
| Provider Name | Martin L Chadwell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508253147 PECOS PAC ID: 2769798008 Enrollment ID: I20181212001234 |
| Provider Name | Melissa A Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265927750 PECOS PAC ID: 5799020194 Enrollment ID: I20181212002665 |
| Provider Name | Marylea R Seacrist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154885895 PECOS PAC ID: 6002157807 Enrollment ID: I20190404000229 |
| Provider Name | Shane Edward Cook |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1942694971 PECOS PAC ID: 4486956570 Enrollment ID: I20190726002922 |
| Provider Name | Dana S Lycans |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003251851 PECOS PAC ID: 8325273774 Enrollment ID: I20190903000186 |
| Provider Name | Glenn Hayes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548641715 PECOS PAC ID: 3971807488 Enrollment ID: I20200416002586 |
| Provider Name | Brad Leonard Lindsey |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1346236072 PECOS PAC ID: 0042104366 Enrollment ID: I20200928001543 |
| Provider Name | Brittany D Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104464999 PECOS PAC ID: 2163833112 Enrollment ID: I20201123001105 |
| Provider Name | Richard Mcneilly |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093087611 PECOS PAC ID: 0547568586 Enrollment ID: I20201210002309 |
| Provider Name | Brandon Scott Murphy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346744281 PECOS PAC ID: 2668724709 Enrollment ID: I20201211000854 |
| Provider Name | Savannah D Jarvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659905297 PECOS PAC ID: 8325450489 Enrollment ID: I20201214001706 |
| Provider Name | Erica Ryan Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639763618 PECOS PAC ID: 0143637074 Enrollment ID: I20210322000651 |
| Provider Name | Steven Lee Jarvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114518123 PECOS PAC ID: 8729495882 Enrollment ID: I20210408000086 |
| Provider Name | Mistafa Asaad Hafid |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760985121 PECOS PAC ID: 8921359365 Enrollment ID: I20210701001714 |
| Provider Name | Jeffrey Werchowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538113782 PECOS PAC ID: 3971502659 Enrollment ID: I20210914001053 |
| Provider Name | Crystal Leigh Gillispie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770250516 PECOS PAC ID: 5597161612 Enrollment ID: I20210914003745 |
| Provider Name | Tiffany Michelle Butcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639845472 PECOS PAC ID: 1850799602 Enrollment ID: I20211007002815 |
| Provider Name | Ryan Rahym Budwany |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1013302140 PECOS PAC ID: 8426328998 Enrollment ID: I20211207000517 |
| Provider Name | Summer Edainah Blount |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1518227164 PECOS PAC ID: 6204125164 Enrollment ID: I20220519000232 |
| Provider Name | Amanda G Messer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487385134 PECOS PAC ID: 9931581238 Enrollment ID: I20220803001713 |
| Provider Name | Dany Tager |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396277158 PECOS PAC ID: 5193090041 Enrollment ID: I20221031002949 |
| Provider Name | Juliana Lea Rollo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083338875 PECOS PAC ID: 2264801901 Enrollment ID: I20221220000191 |
| Provider Name | Marcin Karcz |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1144484569 PECOS PAC ID: 6709001142 Enrollment ID: I20230807001111 |
| Provider Name | Alexandria K Carter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700413390 PECOS PAC ID: 9234553413 Enrollment ID: I20230912001987 |
| Provider Name | Barry Dicicco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093717324 PECOS PAC ID: 3173582392 Enrollment ID: I20240112001770 |
Ernesto T.yutiamco,m.d.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 483 Main St, Madison, WV 25130 Phone: 304-369-0221 Fax: 304-369-0222 | |
Bmh Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 697 Madison Avenue, Madison, WV 25130 Phone: 304-369-1230 Fax: 304-369-6036 | |
Boone Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 State St, Madison, WV 25130 Phone: 304-307-6618 Fax: 304-307-6619 | |
Madison Medical, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 467 Main St, Suite 200, Madison, WV 25130 Phone: 304-369-5170 Fax: 304-369-0946 | |
Women Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Riverside Dr W Rm 308309, Madison, WV 25130 Phone: 304-369-4464 | |
Southern West Virginia Health System-madison Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 471 Main St, Madison, WV 25130 Phone: 304-369-5170 Fax: 304-306-7982 |