Bassett Family Practice | |
324 T B Stanley Hwy Ste B And C Bassett VA 24055-6108 | |
(276) 638-0787 | |
(276) 629-2695 |
Full Name | Bassett Family Practice |
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Speciality | Clinic/Center |
Location | 324 T B Stanley Hwy, Bassett, Virginia |
Authorized Official Name and Position | Gina Finocchiaro (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2764035096 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bassett Family Practice 29 Jones St Martinsville VA 24112-2716 Ph: (276) 638-0787 | Bassett Family Practice 324 T B Stanley Hwy Ste B And C Bassett VA 24055-6108 Ph: (276) 638-0787 |
NPI Number | 1063608081 |
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Provider Enumeration Date | 09/24/2007 |
Last Update Date | 10/16/2024 |
Medicare PECOS PAC ID | 4385717552 |
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Medicare Enrollment ID | O20080721000741 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063608081 | NPI | - | NPPES |
1063608081 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Edna Ekuban-gordon |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1033143466 PECOS PAC ID: 2062405970 Enrollment ID: I20101122000266 |
Provider Name | Amanda Lynn Keith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689034514 PECOS PAC ID: 1557668803 Enrollment ID: I20160411000657 |
Provider Name | Joanna L Carter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477094480 PECOS PAC ID: 7911274097 Enrollment ID: I20180925002983 |
Provider Name | Felecia Harris Mcbride |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275956583 PECOS PAC ID: 9133555220 Enrollment ID: I20200210000559 |
Provider Name | Ashley H Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962032854 PECOS PAC ID: 5597175810 Enrollment ID: I20201027002991 |
Provider Name | Amanda Gail Hatcher |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679183115 PECOS PAC ID: 8820401730 Enrollment ID: I20210114001998 |
Provider Name | Kimberly Sue Gravely |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952998858 PECOS PAC ID: 7416364971 Enrollment ID: I20210329002151 |
Provider Name | Kate Erin Ryan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558865022 PECOS PAC ID: 1254689474 Enrollment ID: I20220131000845 |
Provider Name | Jennifer Walker Phelps |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134798564 PECOS PAC ID: 0345637625 Enrollment ID: I20220505001478 |
Provider Name | Landon R Morrison |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194376608 PECOS PAC ID: 1052745007 Enrollment ID: I20220917000209 |
Provider Name | Rebbecca L Jones |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114931003 PECOS PAC ID: 9931241189 Enrollment ID: I20230207002845 |
Provider Name | Luzmila Zona Via |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740979251 PECOS PAC ID: 5193179034 Enrollment ID: I20230927001112 |
Fatade Health And Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 255 Riverside Dr, Bassett, VA 24055 Phone: 276-627-8070 Fax: 276-627-8069 |