| Community Action Committee Of Pike County | |
|
621 Broadway St Portsmouth OH 45662-4788 | |
| (740) 961-4011 | |
| (740) 961-4010 |
| Full Name | Community Action Committee Of Pike County |
|---|---|
| Speciality | Clinic/Center |
| Location | 621 Broadway St, Portsmouth, Ohio |
| Authorized Official Name and Position | Gary Roberts (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7402892371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Action Committee Of Pike County 941 Market St Piketon OH 45661-9757 Ph: (740) 289-2371 | Community Action Committee Of Pike County 621 Broadway St Portsmouth OH 45662-4788 Ph: (740) 961-4011 |
| NPI Number | 1578974929 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 05/19/2014 |
| Medicare PECOS PAC ID | 3173432762 |
|---|---|
| Medicare Enrollment ID | O20141022000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578974929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Naomi K Blackburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144467002 PECOS PAC ID: 2365599099 Enrollment ID: I20090415000018 |
| Provider Name | Stephanie L Craft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144528019 PECOS PAC ID: 8820271711 Enrollment ID: I20110330001016 |
| Provider Name | Crystal M Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003255266 PECOS PAC ID: 5890939185 Enrollment ID: I20130926000895 |
| Provider Name | Anthony H Arnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295177194 PECOS PAC ID: 1355576737 Enrollment ID: I20131022000386 |
| Provider Name | Rebecca Brewster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144658527 PECOS PAC ID: 1153543210 Enrollment ID: I20141105002207 |
| Provider Name | Joy Puckett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427509884 PECOS PAC ID: 8921412966 Enrollment ID: I20210202002418 |
| Provider Name | Bhupesh Kiran Mandali |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1255888392 PECOS PAC ID: 5294141511 Enrollment ID: I20210311002377 |
| Provider Name | Rebecca E Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104471200 PECOS PAC ID: 2567869357 Enrollment ID: I20210921002532 |
| Provider Name | Bailey Kathleen Caughlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164186425 PECOS PAC ID: 8729479605 Enrollment ID: I20220104000831 |
| Provider Name | Judith Ann Fulton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821519943 PECOS PAC ID: 6608205760 Enrollment ID: I20220916000486 |
| Provider Name | Tessa Rene Gore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073002309 PECOS PAC ID: 8729529672 Enrollment ID: I20240919001675 |
Community Action Committee Of Pike County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 5th St, Portsmouth, OH 45662 Phone: 740-354-6605 | |
Community Action Committee Of Pike County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 5th St, Portsmouth Family Health Center, Portsmouth, OH 45662 Phone: 740-354-6605 | |
Cardiac Examination, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1805 27th St, Portsmouth, OH 45662 Phone: 740-356-8681 Fax: 740-353-7900 | |
John Ditraglia Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 717 5th St, Portsmouth, OH 45662 Phone: 740-354-6605 Fax: 740-354-1565 | |