| New River Primary School Based Health Center | |
|
308 Oyler Ave. Oak Hill WV 25901 | |
| (304) 469-2905 | |
| (304) 469-2981 |
| Full Name | New River Primary School Based Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 308 Oyler Ave., Oak Hill, 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 Primary School Based Health Center 497 Mall Rd Oak Hill WV 25901-6216 Ph: (304) 469-2905 | New River Primary School Based Health Center 308 Oyler Ave. Oak Hill WV 25901 Ph: (304) 469-2905 |
| NPI Number | 1457846362 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 10/09/2023 |
| Medicare PECOS PAC ID | 2365348596 |
|---|---|
| Medicare Enrollment ID | O20210805000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457846362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | 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 | Lora Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700213436 PECOS PAC ID: 8325261308 Enrollment ID: I20140520000996 |
| Provider Name | Crystal Yvonne Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942567763 PECOS PAC ID: 1254551443 Enrollment ID: I20141010001620 |
| Provider Name | Kara J Vosler |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598171316 PECOS PAC ID: 1052623576 Enrollment ID: I20150710002268 |
| Provider Name | Amity L Boblits |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780650416 PECOS PAC ID: 4486066263 Enrollment ID: I20201221000317 |
| Provider Name | Kimberly Carly Nicole Stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053818450 PECOS PAC ID: 1355758954 Enrollment ID: I20210326001593 |
| Provider Name | Joseph Allen Douglas |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1992231674 PECOS PAC ID: 5496147001 Enrollment ID: I20220111001944 |
| Provider Name | Elizabeth Mae Garretson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124755897 PECOS PAC ID: 6901274646 Enrollment ID: I20221130001009 |
Oak Hill Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 96 Lamplighter St, Oak Hill, WV 25901 Phone: 304-929-6930 | |
Petersen Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 Main St W, Suite A, Oak Hill, WV 25901 Phone: 304-465-0544 Fax: 304-465-8832 | |
Oak Hill Clinic Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 320 Jones Ave, Oak Hill, WV 25901 Phone: 304-469-2500 | |
New River Health - Oak Hill Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 497 Mall Rd, Oak Hill, WV 25901 Phone: 304-469-2905 Fax: 304-465-1518 | |
Oak Hill High School Based Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 350 W Oyler Ave, Oak Hill, WV 25901 Phone: 304-469-6331 Fax: 304-469-6332 | |
New River Intermediate School Based Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 262 Oyler Avenue, Oak Hill, WV 25901 Phone: 304-465-2171 Fax: 304-465-2173 |