| St. George Medical Clinic Inc. | |
|
8591 Holly Meadows Rd Parsons WV 26287-8604 | |
| (304) 478-3339 | |
| (304) 478-3311 |
| Full Name | St. George Medical Clinic Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8591 Holly Meadows Rd, Parsons, West Virginia |
| Authorized Official Name and Position | Paul Wamsley (CEO) |
| Authorized Official Contact | 3044783339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. George Medical Clinic Inc. 8591 Holly Meadows Rd Parsons WV 26287-8604 Ph: (304) 478-3339 | St. George Medical Clinic Inc. 8591 Holly Meadows Rd Parsons WV 26287-8604 Ph: (304) 478-3339 |
| NPI Number | 1497853600 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 01/22/2014 |
| Medicare PECOS PAC ID | 7911996244 |
|---|---|
| Medicare Enrollment ID | O20040511000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497853600 | NPI | - | NPPES |
| 0035139000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Jerry M Hahn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831181304 PECOS PAC ID: 7911947056 Enrollment ID: I20060126000024 |
| Provider Name | Iva Elaine Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083636377 PECOS PAC ID: 5890987762 Enrollment ID: I20101011000482 |
| Provider Name | Michelle Cardi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528503513 PECOS PAC ID: 2860768256 Enrollment ID: I20171031000778 |
| Provider Name | Jean L Bridwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104992965 PECOS PAC ID: 0446591929 Enrollment ID: I20190410001180 |
| Provider Name | Misti Dawn Shine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134687114 PECOS PAC ID: 7214364249 Enrollment ID: I20200303001992 |
| Provider Name | Steven Paul Sponaugle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679161129 PECOS PAC ID: 4183039670 Enrollment ID: I20210216000043 |
| Provider Name | Adrianna Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366036972 PECOS PAC ID: 7416356530 Enrollment ID: I20210521002367 |
| Provider Name | Melody Dawn Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811578909 PECOS PAC ID: 7012355175 Enrollment ID: I20240409001498 |
| Provider Name | Amber Gump |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1649712316 PECOS PAC ID: 7012459423 Enrollment ID: I20240612003069 |
Schmitt Family Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 Walnut Street, Parsons, WV 26287 Phone: 304-478-2600 Fax: 304-478-2604 |