Mountain Region Family Medicine, Pc | |
390 Kane St Gate City VA 24251-3407 | |
(276) 386-3411 | |
(276) 286-2492 |
Full Name | Mountain Region Family Medicine, Pc |
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Speciality | Family Medicine |
Location | 390 Kane St, Gate City, Virginia |
Authorized Official Name and Position | Michelle Y Repass (ADMINISTRATIVE ASSISTANT) |
Authorized Official Contact | 2763863411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mountain Region Family Medicine, Pc 390 Kane St Gate City VA 24251-2753 Ph: (276) 386-3411 | Mountain Region Family Medicine, Pc 390 Kane St Gate City VA 24251-3407 Ph: (276) 386-3411 |
NPI Number | 1740292366 |
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Provider Enumeration Date | 08/12/2006 |
Last Update Date | 02/16/2016 |
Medicare PECOS PAC ID | 5890699961 |
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Medicare Enrollment ID | O20090413000113 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740292366 | NPI | - | NPPES |
CA3908 | Other | RAILROAD MEDICARE | |
4401019 | Medicaid | TN | |
037070 | Other | ANTHEM BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Wesley V Eastridge |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457313439 PECOS PAC ID: 5799689873 Enrollment ID: I20100927000173 |
Provider Name | Leslie Brooke Mcnew-hall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811303563 PECOS PAC ID: 3577784958 Enrollment ID: I20141028002668 |
Provider Name | Katelyn M Spitler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952851784 PECOS PAC ID: 0446539084 Enrollment ID: I20180222001516 |
Provider Name | Alysen M Carter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194110346 PECOS PAC ID: 4880941814 Enrollment ID: I20180723002488 |
Provider Name | Monna J. Nelms |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205205317 PECOS PAC ID: 6901115799 Enrollment ID: I20190723002378 |
Mountain Region Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 390 Kane St, Gate City, VA 24251 Phone: 276-386-3411 Fax: 276-386-3492 |