| Mountain Laurel Medical Center | |
|
198 Morgantown St Ste 2 Bruceton Mills WV 26525-5003 | |
| (301) 533-3300 | |
| (833) 448-0361 |
| Full Name | Mountain Laurel Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 198 Morgantown St Ste 2, Bruceton Mills, West Virginia |
| Authorized Official Name and Position | Brian G Bailey (CEO) |
| Authorized Official Contact | 3015333300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Laurel Medical Center 1027 Memorial Dr Oakland MD 21550-4343 Ph: (304) 379-7600 | Mountain Laurel Medical Center 198 Morgantown St Ste 2 Bruceton Mills WV 26525-5003 Ph: (301) 533-3300 |
| NPI Number | 1679269807 |
|---|---|
| Provider Enumeration Date | 04/12/2023 |
| Last Update Date | 08/14/2024 |
| Medicare PECOS PAC ID | 9436152493 |
|---|---|
| Medicare Enrollment ID | O20230804000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679269807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Alysia R Funk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861742629 PECOS PAC ID: 4587800180 Enrollment ID: I20130427000099 |
| Provider Name | Julie A Martinez-aguilar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144545138 PECOS PAC ID: 6901124056 Enrollment ID: I20150421001922 |
| Provider Name | Brittany Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356963300 PECOS PAC ID: 9931528312 Enrollment ID: I20201005000979 |
| Provider Name | Sarah Michelle Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568069110 PECOS PAC ID: 8123431863 Enrollment ID: I20210119001966 |
| Provider Name | Lydia Anna Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770087959 PECOS PAC ID: 0941545651 Enrollment ID: I20220926002559 |
| Provider Name | Melissa C Scott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548558182 PECOS PAC ID: 5496051955 Enrollment ID: I20230804001356 |
| Provider Name | Christopher Michael Ferrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528592516 PECOS PAC ID: 8123396967 Enrollment ID: I20230804002951 |
| Provider Name | Jessica E Nice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295131241 PECOS PAC ID: 5092039784 Enrollment ID: I20230804003624 |
| Provider Name | Abigail Genea Durig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093580938 PECOS PAC ID: 0345699435 Enrollment ID: I20231214002682 |
| Provider Name | Catessa Louise Simon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083966758 PECOS PAC ID: 8123270998 Enrollment ID: I20240403003686 |
Bruceton Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 198 Morgantown St Ste 2, Bruceton Mills, WV 26525 Phone: 304-379-7600 Fax: 304-379-7599 | |
Bruceton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 198 Morgantown Street, Suite B, Bruceton Mills, WV 26525 Phone: 304-379-7600 Fax: 304-379-7599 | |
Harned Memorial Medical Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: One Memorial Drive, Rt 26 North, Bruceton Mills, WV 26525 Phone: 304-379-2114 Fax: 304-379-7929 |