Michelle L Stotts, CRNA | |
720 Pinnell St, Jackson General Hospital, Ripley, WV 25271 | |
(304) 373-1544 | |
(304) 373-0044 |
Full Name | Michelle L Stotts |
---|---|
Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 720 Pinnell St, Ripley, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225079544 | NPI | - | NPPES |
0207026000 | Medicaid | WV | |
DA0096 | Other | WV | RR MEDICARE |
001721843 | Other | WV | BCBS |
001706470 | Other | WV | MSBCBS |
2605278000 | Medicaid | WV | |
P00158674 | Other | WV | RR MEDICARE |
233080009300 | Other | OH | OHIO WORKERS' COMP |
270052997002 | Other | WV | TRICARE |
2435118 | Medicaid | OH | |
2460484 | Medicaid | OH | |
27005299700 | Other | WV | BRICKSTREET |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 52711 (West Virginia) | Primary |
Entity Name | Professional Anesthesia Service,inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720035827 PECOS PAC ID: 2769387190 Enrollment ID: O20031126000731 |
Entity Name | Hospital Development Co. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790745677 PECOS PAC ID: 4183527476 Enrollment ID: O20040406000528 |
Entity Name | West Virginia Health Care Cooperative Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417415324 PECOS PAC ID: 9830431030 Enrollment ID: O20190508000440 |
Entity Name | West Virginia Health Care Cooperative Inc |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1043778319 PECOS PAC ID: 9830431030 Enrollment ID: O20190531001788 |
Mailing Address | Practice Location Address |
---|---|
Michelle L Stotts, CRNA 200 Hospital Dr, Mid Atlantic Anesthesia Consultants, Spencer, WV 25276-1050 Ph: (304) 346-9400 | Michelle L Stotts, CRNA 720 Pinnell St, Jackson General Hospital, Ripley, WV 25271 Ph: (304) 373-1544 |