| Mt. Storm Health Center | |
|
14311 George Washington Highway Mt. Storm WV 26739-0077 | |
| (304) 693-7616 | |
| (304) 693-7776 |
| Full Name | Mt. Storm Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 14311 George Washington Highway, Mt. Storm, West Virginia |
| Authorized Official Name and Position | Beverly J. Snyder (EXECUTIVE ASSISTANT/ACCESS MANAGER) |
| Authorized Official Contact | 3042650312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt. Storm Health Center 25 W Bluemont St Grafton WV 26354-1242 Ph: (304) 265-0312 | Mt. Storm Health Center 14311 George Washington Highway Mt. Storm WV 26739-0077 Ph: (304) 693-7616 |
| NPI Number | 1700819471 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 02/15/2022 |
| Medicare PECOS PAC ID | 3072406438 |
|---|---|
| Medicare Enrollment ID | O20040209000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700819471 | NPI | - | NPPES |
| 3810007992 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary |
| Provider Name | Sara Josefa Chua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770523466 PECOS PAC ID: 0143210351 Enrollment ID: I20040518000342 |
| Provider Name | Andrew M Foy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578549879 PECOS PAC ID: 1456385145 Enrollment ID: I20050922000111 |
| Provider Name | Peter V Wentzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952470841 PECOS PAC ID: 0547260002 Enrollment ID: I20070105000405 |
| Provider Name | Mary C Gainer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932307063 PECOS PAC ID: 8527251990 Enrollment ID: I20101018000713 |
| Provider Name | Kathryn Kahler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487729448 PECOS PAC ID: 4284525130 Enrollment ID: I20111025000890 |
| Provider Name | Erica Renee Gobel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407372097 PECOS PAC ID: 3971879172 Enrollment ID: I20171016001227 |
| Provider Name | Amanda E. Messenger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174094973 PECOS PAC ID: 9830435700 Enrollment ID: I20190114002395 |
| Provider Name | Tomma Kay Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922604651 PECOS PAC ID: 2466888490 Enrollment ID: I20210512000465 |
| Provider Name | Jacqualyn Raupach-spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366101354 PECOS PAC ID: 3577956804 Enrollment ID: I20220210000038 |
| Provider Name | Cynthia Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912631326 PECOS PAC ID: 0244614055 Enrollment ID: I20220829000707 |
| Provider Name | Vanessa Short |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578176228 PECOS PAC ID: 1759765175 Enrollment ID: I20220903000208 |