Waynesburg Clinic, Pllc | |
14098 Us Highway 27 S Waynesburg KY 40489-8253 | |
(606) 379-6646 | |
(606) 379-5707 |
Full Name | Waynesburg Clinic, Pllc |
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Speciality | Clinic/Center |
Location | 14098 Us Highway 27 S, Waynesburg, Kentucky |
Authorized Official Name and Position | Christopher Duvall Sims (MEDICAL DIRECTOR) |
Authorized Official Contact | 6063651547 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Waynesburg Clinic, Pllc Po Box 435 Waynesburg KY 40489-0435 Ph: (606) 379-6646 | Waynesburg Clinic, Pllc 14098 Us Highway 27 S Waynesburg KY 40489-8253 Ph: (606) 379-6646 |
NPI Number | 1669670816 |
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Provider Enumeration Date | 07/10/2007 |
Last Update Date | 10/04/2023 |
Medicare PECOS PAC ID | 3375635857 |
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Medicare Enrollment ID | O20070829000132 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669670816 | NPI | - | NPPES |
7100019500 | Medicaid | KY | |
00361 | Other | KY | MEDICARE PART B |
183954 | Other | KY | MEDICARE PART A |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 900205 (Kentucky) | Primary |
Provider Name | Christopher D Sims |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386687457 PECOS PAC ID: 2668440322 Enrollment ID: I20040921000088 |
Provider Name | Jeanne A Chase |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487799516 PECOS PAC ID: 0446303366 Enrollment ID: I20090724000417 |
Provider Name | Crystal Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063494045 PECOS PAC ID: 4880732320 Enrollment ID: I20091103000711 |
Provider Name | Samantha B Shell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518213776 PECOS PAC ID: 7911137914 Enrollment ID: I20140312001365 |
Provider Name | Jody Coomer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962863407 PECOS PAC ID: 4880991488 Enrollment ID: I20160421000890 |
Provider Name | Jesslyn B Kelsey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346727112 PECOS PAC ID: 9537407028 Enrollment ID: I20190207001473 |
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Faith Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14098 Us Highway 27 S, Waynesburg, KY 40489 Phone: 606-379-6646 | |
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