| New River Health - Smithers | |
|
2 Greyhound Ln. Smithers WV 25186 | |
| (304) 469-2905 | |
| Not Available |
| Full Name | New River Health - Smithers |
|---|---|
| Speciality | Clinic/Center |
| Location | 2 Greyhound Ln., Smithers, West Virginia |
| Authorized Official Name and Position | Marissa Johnson (CREDENTIALING OFFICER) |
| Authorized Official Contact | 3044692905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New River Health - Smithers 497 Mall Rd Oak Hill WV 25901-6216 Ph: (304) 469-2905 | New River Health - Smithers 2 Greyhound Ln. Smithers WV 25186 Ph: (304) 469-2905 |
| NPI Number | 1689220402 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 10/09/2023 |
| Medicare PECOS PAC ID | 2365348596 |
|---|---|
| Medicare Enrollment ID | O20200310000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689220402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Jerry L Pennington |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568655413 PECOS PAC ID: 0840337481 Enrollment ID: I20091030000097 |
| Provider Name | Kerri Elizabeth White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427113299 PECOS PAC ID: 1557547668 Enrollment ID: I20110525000172 |
| Provider Name | Kara J Vosler |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598171316 PECOS PAC ID: 1052623576 Enrollment ID: I20150710002268 |
| Provider Name | Rebecca Dilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831508951 PECOS PAC ID: 7214279850 Enrollment ID: I20190430001962 |
| Provider Name | Locienda Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629689484 PECOS PAC ID: 1850710005 Enrollment ID: I20201007002336 |
| Provider Name | Erica Ryan Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639763618 PECOS PAC ID: 0143637074 Enrollment ID: I20210322000651 |
| Provider Name | John M Falbo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356350102 PECOS PAC ID: 8527383108 Enrollment ID: I20210722000220 |
Valley School Based Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 59 Greyhound Ln, Smithers, WV 25186 Phone: 304-981-4983 Fax: 304-981-4949 |