|
| |
|
301 Falls Dr Nw Ste 353 Abingdon VA 24210-8093 | |
| (800) 805-6989 | |
| (864) 558-8511 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Falls Dr Nw Ste 353, Abingdon, Virginia |
| Authorized Official Name and Position | Rupert Mccormac (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8008056989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 749057 Atlanta GA 30374-9057 Ph: (800) 805-6989 | 301 Falls Dr Nw Ste 353 Abingdon VA 24210-8093 Ph: (800) 805-6989 |
| NPI Number | 1760949127 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 9931535820 |
|---|---|
| Medicare Enrollment ID | O20200213000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760949127 | NPI | - | NPPES |
| Provider Name | Zelda West Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801933007 PECOS PAC ID: 1153310073 Enrollment ID: I20040506001747 |
| Provider Name | Meenakshi Gopal |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1003861915 PECOS PAC ID: 7012998172 Enrollment ID: I20061003000416 |
| Provider Name | Shazia Habib Farooqi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770699613 PECOS PAC ID: 7911001763 Enrollment ID: I20070403000607 |
| Provider Name | Ronald L Schubert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982670493 PECOS PAC ID: 2567537087 Enrollment ID: I20080819000242 |
| Provider Name | Robert N Lowe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134158470 PECOS PAC ID: 9739249152 Enrollment ID: I20081114000621 |
| Provider Name | Sheree L Savage-artis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841665163 PECOS PAC ID: 2264739879 Enrollment ID: I20160328000221 |
| Provider Name | Denny Ray Goss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235573478 PECOS PAC ID: 0648591487 Enrollment ID: I20160713000062 |
| Provider Name | Rebekah P Peery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144536509 PECOS PAC ID: 2062769888 Enrollment ID: I20180724003130 |
| Provider Name | William B Wolf |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1316262124 PECOS PAC ID: 7012968522 Enrollment ID: I20190212001858 |
| Provider Name | Cynthia Davis Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982174900 PECOS PAC ID: 7416295316 Enrollment ID: I20190220000189 |
| Provider Name | Amanda C Higgs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861901506 PECOS PAC ID: 5294169785 Enrollment ID: I20191216001165 |
| Provider Name | Evelyne Kingori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821650177 PECOS PAC ID: 9032544101 Enrollment ID: I20200203000255 |
| Provider Name | Cameron A Brown |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1932484490 PECOS PAC ID: 5991039323 Enrollment ID: I20201007000904 |
| Provider Name | Gelila Tesfaye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407404452 PECOS PAC ID: 8022426741 Enrollment ID: I20210419002083 |
| Provider Name | Elizabeth K Villafane-sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033881834 PECOS PAC ID: 8628462967 Enrollment ID: I20220302000464 |
| Provider Name | Sheri Kena Yarber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639817083 PECOS PAC ID: 6709261670 Enrollment ID: I20220913001061 |
| Provider Name | Ray Anthony Mercado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275606030 PECOS PAC ID: 6305960337 Enrollment ID: I20221108002768 |
| Provider Name | Mellissa Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922683036 PECOS PAC ID: 6103295282 Enrollment ID: I20221212002551 |
| Provider Name | Sarah E. Simerly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033530209 PECOS PAC ID: 6204051550 Enrollment ID: I20240201001220 |
| Provider Name | Jennifer Lynn Estep |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548906183 PECOS PAC ID: 9436590015 Enrollment ID: I20240514001819 |
| Provider Name | Mindy Tran Ngu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013580992 PECOS PAC ID: 4981149259 Enrollment ID: I20240710004307 |
| Provider Name | Tara Jill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043789209 PECOS PAC ID: 9032552542 Enrollment ID: I20240717003623 |
| Provider Name | Heidi Monika Nealey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790495778 PECOS PAC ID: 2365981941 Enrollment ID: I20240827002826 |
| Provider Name | Beverly L Cobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902527385 PECOS PAC ID: 8123463064 Enrollment ID: I20241023004090 |
| Provider Name | Matthew Thomas Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477046894 PECOS PAC ID: 5991047193 Enrollment ID: I20241031002660 |
| Provider Name | Amber Star Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205987047 PECOS PAC ID: 2062675812 Enrollment ID: I20241112002036 |
| Provider Name | Tierra Royal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205696010 PECOS PAC ID: 8123553823 Enrollment ID: I20241118003529 |
| Provider Name | Matthew Lamar Mason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689412074 PECOS PAC ID: 8628503752 Enrollment ID: I20241126000423 |
Full Circle Therapy, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 190 E Main St, Abingdon, VA 24210 Phone: 276-738-4831 Fax: 844-444-0697 | |
Hope Over My Experiences Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 Pippin St Nw, Abingdon, VA 24210 Phone: 276-492-5556 | |
Sw Va Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 361b Falls Dr Nw, Abingdon, VA 24210 Phone: 276-628-5752 Fax: 276-628-5190 | |
Kayla C. Loudy, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 E Main St, Abingdon, VA 24210 Phone: 276-628-2510 | |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 297 Stanley St, Abingdon, VA 24210 Phone: 276-623-9245 | |
Kathleen P Baldwin Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Cummings Street, Abingdon, VA 24210 Phone: 276-628-5300 Fax: 276-628-5351 |