| Tygart Valley Professional Fees | |
|
1 Hospital Plz Grafton WV 26354-1283 | |
| (304) 265-7406 | |
| (304) 265-6419 |
| Full Name | Tygart Valley Professional Fees |
|---|---|
| Speciality | General Practice |
| Location | 1 Hospital Plz, Grafton, West Virginia |
| Authorized Official Name and Position | George Boyles (INTERIM CEO) |
| Authorized Official Contact | 3042657151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tygart Valley Professional Fees 1 Hospital Plz Grafton WV 26354-1283 Ph: (304) 265-7406 | Tygart Valley Professional Fees 1 Hospital Plz Grafton WV 26354-1283 Ph: (304) 265-7406 |
| NPI Number | 1033264387 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 01/03/2020 |
| Certification Date | 01/03/2020 |
| Medicare PECOS PAC ID | 7719897263 |
|---|---|
| Medicare Enrollment ID | O20040513000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033264387 | NPI | - | NPPES |
| 3330106001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Stephanie D Ruud |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235116773 PECOS PAC ID: 2961470844 Enrollment ID: I20040918000192 |
| Provider Name | Louis a Yancich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861432593 PECOS PAC ID: 9830169366 Enrollment ID: I20041001001093 |
| Provider Name | Thomas Flemin Wilshire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033167630 PECOS PAC ID: 7810936382 Enrollment ID: I20050426000282 |
| Provider Name | Teresa L Harriman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629037312 PECOS PAC ID: 8325075195 Enrollment ID: I20050722000800 |
| Provider Name | Mouhannad Azzouz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760506018 PECOS PAC ID: 8022022664 Enrollment ID: I20060207000515 |
| Provider Name | Christopher William Edwards |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033301304 PECOS PAC ID: 4688760770 Enrollment ID: I20071022000001 |
| Provider Name | Jeffrey B Sinclair |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184715880 PECOS PAC ID: 6608954391 Enrollment ID: I20080422000153 |
| Provider Name | Gregory P Selasky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417119736 PECOS PAC ID: 2567537483 Enrollment ID: I20080812000429 |
| Provider Name | Edward P Brennan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316117815 PECOS PAC ID: 0547326001 Enrollment ID: I20090306000593 |
| Provider Name | Teresa M Olivo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912238775 PECOS PAC ID: 7012051212 Enrollment ID: I20100225000177 |
| Provider Name | David Bender |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1891892626 PECOS PAC ID: 5799829941 Enrollment ID: I20100225000641 |
| Provider Name | Jennifer G Shreves |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356451702 PECOS PAC ID: 7012052525 Enrollment ID: I20100309000459 |
| Provider Name | Joseph Hugo Duvert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700984473 PECOS PAC ID: 7214979756 Enrollment ID: I20100324000276 |
| Provider Name | Crystal Darlene Rucker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699873257 PECOS PAC ID: 6204960180 Enrollment ID: I20100813000559 |
| Provider Name | David a Anderson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225062631 PECOS PAC ID: 8820114200 Enrollment ID: I20100922000916 |
| Provider Name | Michelle M Purdy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750368296 PECOS PAC ID: 1759563943 Enrollment ID: I20110309000429 |
| Provider Name | Robert a Burnside |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184918385 PECOS PAC ID: 5395913081 Enrollment ID: I20110725000315 |
| Provider Name | Song Lu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073763454 PECOS PAC ID: 0244402725 Enrollment ID: I20111005000155 |
| Provider Name | Ryan Wakim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093033789 PECOS PAC ID: 3375702731 Enrollment ID: I20120306000019 |
| Provider Name | Stephen Lynn Harris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821195637 PECOS PAC ID: 3971766023 Enrollment ID: I20120530000050 |
| Provider Name | Amelia Adcock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497982623 PECOS PAC ID: 5698915270 Enrollment ID: I20131028001149 |
| Provider Name | Lola J Burke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972897684 PECOS PAC ID: 0244458131 Enrollment ID: I20140908000722 |
| Provider Name | Justin M Spratt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396974044 PECOS PAC ID: 4183853047 Enrollment ID: I20140925001719 |
| Provider Name | Jeanette D Woods |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861813412 PECOS PAC ID: 8628390861 Enrollment ID: I20141125001739 |
| Provider Name | Heather Dawn Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396128047 PECOS PAC ID: 9335455880 Enrollment ID: I20150831000343 |
| Provider Name | Muhammad Alvi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629396478 PECOS PAC ID: 7810133543 Enrollment ID: I20151027002893 |
| Provider Name | Thomas Matthew Stevens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659719698 PECOS PAC ID: 6204067747 Enrollment ID: I20151118002873 |
| Provider Name | Samantha Jane Crites |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679898290 PECOS PAC ID: 7810299633 Enrollment ID: I20160111000799 |
| Provider Name | Umer Najib |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144512880 PECOS PAC ID: 9830497239 Enrollment ID: I20160419001328 |
| Provider Name | Ann Murray |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194081968 PECOS PAC ID: 3274835921 Enrollment ID: I20160627000701 |
| Provider Name | Theodore Lawrence Katner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922233600 PECOS PAC ID: 2466673785 Enrollment ID: I20161025001903 |
| Provider Name | Jason Likens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265872741 PECOS PAC ID: 2769785351 Enrollment ID: I20170829000343 |
| Provider Name | Andrew Berardinelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730591124 PECOS PAC ID: 4981821634 Enrollment ID: I20170929002054 |
| Provider Name | Ikenna S Nzeogu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821068420 PECOS PAC ID: 0941110613 Enrollment ID: I20171116000575 |
| Provider Name | Vincent Schieffer Linberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033592654 PECOS PAC ID: 1456655968 Enrollment ID: I20171117002464 |
| Provider Name | Danielle Paige Holmes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144791708 PECOS PAC ID: 4880933365 Enrollment ID: I20190227002068 |
| Provider Name | Amy Elizabeth Gutshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750934816 PECOS PAC ID: 4082942271 Enrollment ID: I20190827000055 |
| Provider Name | Avery Gookin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356999312 PECOS PAC ID: 1355777905 Enrollment ID: I20200130001928 |
| Provider Name | Steven Gregory Mclaughlin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558353185 PECOS PAC ID: 9537144365 Enrollment ID: I20210301002190 |
| Provider Name | Joseph Greschner |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508397696 PECOS PAC ID: 6709157241 Enrollment ID: I20220712001778 |
| Provider Name | Amber Rose Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457916405 PECOS PAC ID: 7012399850 Enrollment ID: I20220727000055 |
| Provider Name | Clara Renee Larew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376263483 PECOS PAC ID: 1254708233 Enrollment ID: I20221103002035 |
| Provider Name | Dustin JL Baldwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144377557 PECOS PAC ID: 8022172329 Enrollment ID: I20230619001103 |
| Provider Name | Ann Marie Whitehair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609554393 PECOS PAC ID: 1052772019 Enrollment ID: I20230807003467 |
| Provider Name | Farman Ali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164927471 PECOS PAC ID: 8426410994 Enrollment ID: I20230815003201 |
| Provider Name | Ahmad Zamzam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558853705 PECOS PAC ID: 4880949056 Enrollment ID: I20230907003807 |
| Provider Name | Madison White |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215631080 PECOS PAC ID: 2567820244 Enrollment ID: I20240412003070 |
| Provider Name | Daniel Getlik |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700504552 PECOS PAC ID: 1557802550 Enrollment ID: I20240918000486 |
| Provider Name | Barbara Alesha Adkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386194264 PECOS PAC ID: 3779076658 Enrollment ID: I20251201001914 |
Tygart Valley Total Care Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 Market St, Grafton, WV 26354 Phone: 304-265-0400 Fax: 304-265-6417 |
Anna Jarvis Elementary School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 N Pike St, Grafton, WV 26354 Phone: 304-265-4090 |
Grafton High School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Yates Ave, Grafton, WV 26354 Phone: 304-265-3046 |
Dental Center of Taylor County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 711 N Pike St, Grafton, WV 26354 Phone: 304-265-4600 Fax: 304-265-6008 |
Medical Center of Taylor Co. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 N Pike St, Grafton, WV 26354 Phone: 304-265-4909 Fax: 304-265-4916 |
Preston Taylor Community Health Centers, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 North Pike Street, Grafton, WV 26354 Phone: 304-265-0312 Fax: 304-265-0314 |