Upmc Western Maryland Corporation | |
45 Hunt Club Dr Ridgeley WV 26753-7567 | |
(304) 726-4501 | |
(304) 726-4051 |
Full Name | Upmc Western Maryland Corporation |
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Speciality | Clinic/Center |
Location | 45 Hunt Club Dr, Ridgeley, West Virginia |
Authorized Official Name and Position | Amber Ruble (CFO) |
Authorized Official Contact | 2409648032 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Upmc Western Maryland Corporation 600 Grant Street, Us Steel Tower, 59th Floor C/o Renee Johnson Pittsburgh PA 15219-1671 Ph: (412) 623-6303 | Upmc Western Maryland Corporation 45 Hunt Club Dr Ridgeley WV 26753-7567 Ph: (304) 726-4501 |
NPI Number | 1215558416 |
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Provider Enumeration Date | 04/29/2020 |
Last Update Date | 06/13/2023 |
Medicare PECOS PAC ID | 7113900655 |
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Medicare Enrollment ID | O20200609001290 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215558416 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Lynn Metcalf |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538444369 PECOS PAC ID: 8224293634 Enrollment ID: I20120710000782 |
Provider Name | Rondal Zapf |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659709558 PECOS PAC ID: 8729210786 Enrollment ID: I20160606001061 |
Provider Name | James Deren |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053310078 PECOS PAC ID: 1456433549 Enrollment ID: I20161026002740 |
Provider Name | Amit S Kalaria |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1578510897 PECOS PAC ID: 4183652936 Enrollment ID: I20161031001858 |
Provider Name | Rebekah J Haywood |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942672704 PECOS PAC ID: 3072813492 Enrollment ID: I20170314001250 |
Provider Name | Michael G Cetta |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1609803345 PECOS PAC ID: 7810945540 Enrollment ID: I20170602001017 |
Provider Name | Jeremy R Hunt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144465600 PECOS PAC ID: 2769651579 Enrollment ID: I20170828000273 |
Provider Name | Angelina Musselman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851780365 PECOS PAC ID: 2860713443 Enrollment ID: I20180209001452 |
Provider Name | Crystal Lynne Walls |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396222998 PECOS PAC ID: 9931459922 Enrollment ID: I20181112000488 |
Provider Name | Nicole Bonner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770733248 PECOS PAC ID: 1456538297 Enrollment ID: I20190612002274 |
Provider Name | Jeremy Steward |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346769742 PECOS PAC ID: 7113285347 Enrollment ID: I20191021001200 |
Provider Name | Ronald Clifford Kinsey |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1477580660 PECOS PAC ID: 4082647755 Enrollment ID: I20200717000262 |
Provider Name | Robert Jason Hallock |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1043265804 PECOS PAC ID: 3173521580 Enrollment ID: I20200720001121 |