Coal River Primary is a medicare enrolled primary clinic (Nurse Practitioner - Family) in Nellis, West Virginia. The current practice location for Coal River Primary is 62 Fork Creek Rd, Nellis, West Virginia. For appointments, you can reach them via phone at
(304) 833-0815. The mailing address for Coal River Primary is 62 Fork Creek Rd, Nellis, West Virginia and phone number is (304) 833-0815.
Coal River Primary is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1487284451. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(304) 833-0815.
Primary Care Clinic Profile
| Full Name | Coal River Primary |
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| Speciality | Nurse Practitioner |
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| Location | 62 Fork Creek Rd, Nellis, West Virginia |
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| Authorized Official Name and Position | Rebecca Ruby Barker (SOLE OWNER; FNP-BC) |
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| Authorized Official Contact | 3048330815 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Coal River Primary
62 Fork Creek Rd
Nellis
WV 25142-9737
Ph: (304) 833-0815 | Coal River Primary
62 Fork Creek Rd
Nellis
WV 25142-9737
Ph: (304) 833-0815 |
NPI Details:
| NPI Number | 1487284451 |
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| Provider Enumeration Date | 01/18/2020 |
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| Last Update Date | 04/05/2022 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 0042649642 |
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| Medicare Enrollment ID | O20200402001856 |
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Medical Identifiers
Medical identifiers for Coal River Primary such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487284451 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| 364SF0001X | Clinical Nurse Specialist - Family Health | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Coal River Primary acts as a billing entity for following providers:
| Provider Name | Rebecca Ruby Barker |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1134472525
PECOS PAC ID: 6608012307
Enrollment ID: I20130425000355 |
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