| Preston Taylor Community Health Centers, Incorporated | |
| 14311 George Washington Highway Mt. Storm WV 26739-0077 | |
| (304) 693-7616 | |
| (304) 693-7776 | 
| Full Name | Preston Taylor Community Health Centers, Incorporated | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 14311 George Washington Highway, Mt. Storm, West Virginia | 
| Authorized Official Name and Position | Beverly J. Snyder (EXECUTIVE ASSISTANT/ACCESS MANAGER) | 
| Authorized Official Contact | 3042650312 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Preston Taylor Community Health Centers, Incorporated 25 W Bluemont St Grafton WV 26354-1242 Ph: (304) 265-0312 | Preston Taylor Community Health Centers, Incorporated 14311 George Washington Highway Mt. Storm WV 26739-0077 Ph: (304) 693-7616 | 
| NPI Number | 1700819471 | 
|---|---|
| Provider Enumeration Date | 07/08/2006 | 
| Last Update Date | 02/15/2022 | 
| Medicare PECOS PAC ID | 3072406438 | 
|---|---|
| Medicare Enrollment ID | O20040209000039 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1700819471 | NPI | - | NPPES | 
| 3810007992 | Medicaid | WV | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary | 
| Provider Name | Sara Josefa Chua | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1770523466 PECOS PAC ID: 0143210351 Enrollment ID: I20040518000342 | 
| Provider Name | Andrew M Foy | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1578549879 PECOS PAC ID: 1456385145 Enrollment ID: I20050922000111 | 
| Provider Name | Peter V Wentzel | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1952470841 PECOS PAC ID: 0547260002 Enrollment ID: I20070105000405 | 
| Provider Name | Mary C Gainer | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1932307063 PECOS PAC ID: 8527251990 Enrollment ID: I20101018000713 | 
| Provider Name | Kathryn Kahler | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1487729448 PECOS PAC ID: 4284525130 Enrollment ID: I20111025000890 | 
| Provider Name | Megan Dawn Weese | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1487918082 PECOS PAC ID: 6800118860 Enrollment ID: I20141201002164 | 
| Provider Name | Erica Renee Gobel | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1407372097 PECOS PAC ID: 3971879172 Enrollment ID: I20171016001227 | 
| Provider Name | Brooklyn Ayersman | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1134657851 PECOS PAC ID: 6204194905 Enrollment ID: I20180102001273 | 
| Provider Name | Amanda E. Messenger | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1174094973 PECOS PAC ID: 9830435700 Enrollment ID: I20190114002395 | 
| Provider Name | Tomma Kay Mcdaniel | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1922604651 PECOS PAC ID: 2466888490 Enrollment ID: I20210512000465 | 
| Provider Name | Cynthia Harper | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1912631326 PECOS PAC ID: 0244614055 Enrollment ID: I20220829000707 | 
| Provider Name | Vanessa Short | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1578176228 PECOS PAC ID: 1759765175 Enrollment ID: I20220903000208 |