| 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 | 04/21/2026 |
| Certification Date | 04/21/2026 |
| 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 | Lisa Skinner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720042518 PECOS PAC ID: 6406747765 Enrollment ID: I20040324000790 |
| Provider Name | Muhammed a Khan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467479006 PECOS PAC ID: 3375434558 Enrollment ID: I20040324001609 |
| 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 | Michael E. Anton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740284371 PECOS PAC ID: 2668450420 Enrollment ID: I20040709000252 |
| Provider Name | Frank Charles Lucente |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306932140 PECOS PAC ID: 0648259697 Enrollment ID: I20040714001319 |
| Provider Name | John D Anton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508860438 PECOS PAC ID: 9537131271 Enrollment ID: I20040812000028 |
| 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 | Jerry a Quisenberry |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639111768 PECOS PAC ID: 8628006145 Enrollment ID: I20050727000178 |
| Provider Name | Nicholas C Vance |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528007705 PECOS PAC ID: 0648200089 Enrollment ID: I20050816000707 |
| 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 | John a Deluca |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407942345 PECOS PAC ID: 4880628130 Enrollment ID: I20050926000593 |
| Provider Name | Jody L Asbury |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295711687 PECOS PAC ID: 2668490988 Enrollment ID: I20051104000668 |
| Provider Name | Amy Parker Sayre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528025350 PECOS PAC ID: 6103807052 Enrollment ID: I20051107000491 |
| Provider Name | Wiley H Kent |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205900974 PECOS PAC ID: 1658390257 Enrollment ID: I20051114000224 |
| 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 | Ashley R Grimmett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417047242 PECOS PAC ID: 4082612189 Enrollment ID: I20061128000564 |
| Provider Name | Ronald D Chattin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770597171 PECOS PAC ID: 3779584727 Enrollment ID: I20070118000288 |
| Provider Name | Jimi L Baisden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144302878 PECOS PAC ID: 0143327437 Enrollment ID: I20070522000153 |
| Provider Name | Ziad a Chanaa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720172760 PECOS PAC ID: 3375630551 Enrollment ID: I20071105000391 |
| Provider Name | Stephen J Albright |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811183429 PECOS PAC ID: 0547358848 Enrollment ID: I20071121000000 |
| 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 | Aaron L Sop |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073661096 PECOS PAC ID: 6507921921 Enrollment ID: I20090219000244 |
| 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 | Kevin D Hill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306813563 PECOS PAC ID: 7517019458 Enrollment ID: I20090723000413 |
| Provider Name | Tarah R Hager |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205169240 PECOS PAC ID: 0042356537 Enrollment ID: I20091014000495 |
| 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 | Kimberly Bush Uy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245266840 PECOS PAC ID: 8527952357 Enrollment ID: I20100415000051 |
| 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 | Justin Douglas |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326210857 PECOS PAC ID: 0143353037 Enrollment ID: I20100728001268 |
| Provider Name | Kelly Ann Hager |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881852549 PECOS PAC ID: 3274690508 Enrollment ID: I20100907001097 |
| Provider Name | Eric E Stollings |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710942735 PECOS PAC ID: 7214129899 Enrollment ID: I20101014000793 |
| 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 | Bill Boshell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689885972 PECOS PAC ID: 5092866350 Enrollment ID: I20110316000032 |
| 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 | Chad Baisden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043508088 PECOS PAC ID: 7012187396 Enrollment ID: I20110823001076 |
| Provider Name | Heather Jones Robinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245377811 PECOS PAC ID: 6406958677 Enrollment ID: I20120125000805 |
| 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 | Mark Burch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649692765 PECOS PAC ID: 2769613421 Enrollment ID: I20140321000004 |
| Provider Name | Jamie L Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083056345 PECOS PAC ID: 7810129376 Enrollment ID: I20140415001817 |
| Provider Name | Ricky Mcdaniels |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700297207 PECOS PAC ID: 4981820529 Enrollment ID: I20140717000608 |
| Provider Name | Andrew Bryant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194018093 PECOS PAC ID: 7113157637 Enrollment ID: I20140918001392 |
| Provider Name | Casey Flint |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578962676 PECOS PAC ID: 0648593988 Enrollment ID: I20141218000057 |
| 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 | Lisa a Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912317629 PECOS PAC ID: 8921322942 Enrollment ID: I20150122002339 |
| Provider Name | Deborah Townsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881079614 PECOS PAC ID: 3577872993 Enrollment ID: I20151026000048 |
| Provider Name | Marcus a Peters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104187756 PECOS PAC ID: 9234360082 Enrollment ID: I20151111000202 |
| Provider Name | Faranak Sadri Tafazoli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790717221 PECOS PAC ID: 7214005750 Enrollment ID: I20160518001516 |
| 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 | Angela 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 | Jackson Barkley Austin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346763786 PECOS PAC ID: 2961768775 Enrollment ID: I20171110002456 |
| Provider Name | Heather Kay Legg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154844249 PECOS PAC ID: 6406112945 Enrollment ID: I20171115003751 |
| Provider Name | Tammi E Blankenship |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477042943 PECOS PAC ID: 2769737279 Enrollment ID: I20180622002473 |
| Provider Name | Daniel R Wright |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1437535267 PECOS PAC ID: 8022380542 Enrollment ID: I20180810000970 |
| 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 Pitafi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023115615 PECOS PAC ID: 8921250044 Enrollment ID: I20181029001366 |
| Provider Name | Makenzie T Tiller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871089508 PECOS PAC ID: 8426301730 Enrollment ID: I20181101002799 |
| Provider Name | Jalal U Akbar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720063795 PECOS PAC ID: 3971559626 Enrollment ID: I20181101002875 |
| Provider Name | Derrick Green |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1952644460 PECOS PAC ID: 5597068981 Enrollment ID: I20181101003348 |
| 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 | Crystal L Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790272607 PECOS PAC ID: 0648515841 Enrollment ID: I20181217000985 |
| Provider Name | Casey Shannon Hatfield |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710456561 PECOS PAC ID: 3476894270 Enrollment ID: I20190404000166 |
| 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 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 | Printess Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124667266 PECOS PAC ID: 3375950314 Enrollment ID: I20210318001704 |
| 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 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 R Budwany |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1013302140 PECOS PAC ID: 8426328998 Enrollment ID: I20211207000517 |
| Provider Name | Stuart O'byrne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871608539 PECOS PAC ID: 4587794862 Enrollment ID: I20220204001810 |
| Provider Name | Summer 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 K 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 | Lucas Bracero |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1699270991 PECOS PAC ID: 4284962846 Enrollment ID: I20231122003434 |
| Provider Name | Barry Dicicco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093717324 PECOS PAC ID: 3173582392 Enrollment ID: I20240112001770 |
| Provider Name | Sandra Bernadine Vance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174008239 PECOS PAC ID: 2264761451 Enrollment ID: I20240319000108 |
| Provider Name | James Logan Shadowfax Frame |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770268427 PECOS PAC ID: 3072950989 Enrollment ID: I20240326004427 |
| Provider Name | Diana Alec Elkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457115560 PECOS PAC ID: 9537500798 Enrollment ID: I20240518000655 |
| Provider Name | Jacqueline Mary Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811651052 PECOS PAC ID: 7719425792 Enrollment ID: I20240821004075 |
| Provider Name | Rafay Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093086282 PECOS PAC ID: 3274799150 Enrollment ID: I20241111003768 |
| Provider Name | Michel Jeannot |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700023330 PECOS PAC ID: 9335292051 Enrollment ID: I20241114000294 |
| Provider Name | Robert Zickafoose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003639865 PECOS PAC ID: 9133657950 Enrollment ID: I20250107004175 |
| Provider Name | Shahid Bashir |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982751244 PECOS PAC ID: 5991750614 Enrollment ID: I20250124002626 |
| Provider Name | Steven Koenig |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1669513321 PECOS PAC ID: 6901814201 Enrollment ID: I20250318000902 |
| Provider Name | Ryan D Nichols |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215378872 PECOS PAC ID: 1557582129 Enrollment ID: I20250421000926 |
| Provider Name | Norman M Jacobs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407856214 PECOS PAC ID: 8022917517 Enrollment ID: I20250428000272 |
| Provider Name | Jonathan Joseph Callegari |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831571207 PECOS PAC ID: 1052629540 Enrollment ID: I20250605000700 |
| Provider Name | Fahima Hannoufa |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861257537 PECOS PAC ID: 7113439506 Enrollment ID: I20250623001151 |
| Provider Name | Vincent P Morra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861979312 PECOS PAC ID: 5395146302 Enrollment ID: I20250728001667 |
| Provider Name | Dustin L Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033439492 PECOS PAC ID: 7012104763 Enrollment ID: I20250821000181 |
| Provider Name | Seth a Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225583347 PECOS PAC ID: 8123443876 Enrollment ID: I20250916001628 |
| Provider Name | Anuj Shah |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1023639036 PECOS PAC ID: 7618399924 Enrollment ID: I20250919003652 |
| Provider Name | Jeffrey Tsai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528216090 PECOS PAC ID: 2769654581 Enrollment ID: I20250920000030 |
| Provider Name | Crysela M Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942528021 PECOS PAC ID: 9032439369 Enrollment ID: I20250920000039 |
| Provider Name | Loretta a Settonni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023011137 PECOS PAC ID: 7214824762 Enrollment ID: I20250926002250 |
| Provider Name | Nicholas M Thomas-bock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902285117 PECOS PAC ID: 3375840937 Enrollment ID: I20250926002366 |
| Provider Name | Steven L Woolley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831189935 PECOS PAC ID: 4082895321 Enrollment ID: I20251001002572 |
| Provider Name | Matthew Hrastich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669453866 PECOS PAC ID: 9133272446 Enrollment ID: I20251001002659 |
| Provider Name | Frank E Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306854500 PECOS PAC ID: 9436053964 Enrollment ID: I20251010002905 |
| Provider Name | Aun Hussain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184056202 PECOS PAC ID: 5092067439 Enrollment ID: I20251017003723 |
| Provider Name | Jeffrey Clark |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699739946 PECOS PAC ID: 6103953344 Enrollment ID: I20251031000167 |
| Provider Name | Julie Heather Hausmann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790910362 PECOS PAC ID: 2264945609 Enrollment ID: I20251231003010 |
| Provider Name | Jeffrey Boyd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508043522 PECOS PAC ID: 8527190156 Enrollment ID: I20260206002709 |
| Provider Name | Patrick Mcdonough |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558697599 PECOS PAC ID: 2365680212 Enrollment ID: I20260207000199 |
| Provider Name | Adam Evans |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053748822 PECOS PAC ID: 0446573943 Enrollment ID: I20260209002517 |
| Provider Name | Katherine Cyran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801868351 PECOS PAC ID: 6103833777 Enrollment ID: I20260209004031 |
| Provider Name | Edward Martinek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275589475 PECOS PAC ID: 4789656414 Enrollment ID: I20260212000486 |
| Provider Name | Jami Lyon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083057178 PECOS PAC ID: 8325398704 Enrollment ID: I20260215000188 |
| Provider Name | Scott G Akin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366447401 PECOS PAC ID: 1052211851 Enrollment ID: I20260218002788 |
| Provider Name | Nathan Bennington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972777589 PECOS PAC ID: 2668641820 Enrollment ID: I20260219002976 |
| Provider Name | Rife Huckabee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215930813 PECOS PAC ID: 1153309042 Enrollment ID: I20260220002948 |
| Provider Name | John Scott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336533694 PECOS PAC ID: 3274881909 Enrollment ID: I20260220003574 |
| Provider Name | Tyler Evans |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538494513 PECOS PAC ID: 8921247206 Enrollment ID: I20260226001755 |
| Provider Name | Robert Roach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295725398 PECOS PAC ID: 7416140082 Enrollment ID: I20260226003256 |
| Provider Name | Elyor Vidal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255838256 PECOS PAC ID: 3274937982 Enrollment ID: I20260228000240 |
| Provider Name | Christopher John |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669679569 PECOS PAC ID: 6002047370 Enrollment ID: I20260228000862 |
| Provider Name | Scott Logan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154321867 PECOS PAC ID: 1355249319 Enrollment ID: I20260309001669 |
| Provider Name | Jacob Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578891917 PECOS PAC ID: 1052598646 Enrollment ID: I20260311000933 |
| Provider Name | Tabitha Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982557013 PECOS PAC ID: 1153804794 Enrollment ID: I20260312000686 |
| Provider Name | Natalia Gaulke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295054047 PECOS PAC ID: 8820237415 Enrollment ID: I20260312001999 |
| Provider Name | Devon O'guinn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215381116 PECOS PAC ID: 7810257037 Enrollment ID: I20260313000034 |
| Provider Name | Richard Rosenblum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306834270 PECOS PAC ID: 9931149531 Enrollment ID: I20260323001543 |
| Provider Name | Kalpesh Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639185580 PECOS PAC ID: 3274631486 Enrollment ID: I20260413003150 |
| Provider Name | Syed Raza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740252139 PECOS PAC ID: 6709840622 Enrollment ID: I20260504007778 |
| Provider Name | Richard Jennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891777975 PECOS PAC ID: 9739100801 Enrollment ID: I20260508000017 |
| Provider Name | Anthony Leblanc |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356799068 PECOS PAC ID: 1254734098 Enrollment ID: I20260508002269 |
| Provider Name | Syed Jafri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386052280 PECOS PAC ID: 4082957923 Enrollment ID: I20260513003124 |
| Provider Name | Elie M Saab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447218169 PECOS PAC ID: 0547163123 Enrollment ID: I20260520000500 |
| Provider Name | Divya Kumari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669881702 PECOS PAC ID: 9739413097 Enrollment ID: I20260610003578 |
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 |
Familycare Health Centers 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 |