Adam M Penfold, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2610 Issued in WV

Practice address

2373 W Main St
Ste 102
Salem, WV 26426-7515

Phone

(304) 782-2000

Fax

(304) 782-3102

NPI assigned

Jun 23, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• United Physicians Care Inc

  • Family Medicine Physician
  • Shinnston, WV
  • NPI 1184849200
  Medicare reassignment NPD
• United Physicians Care Inc

  dba Pinewood Medical Center

  • Family Medicine Physician
  • Grafton, WV
  • NPI 1891863874
  NPD
• Salem Family Medicine Inc

  • Family Medicine Physician
  • Salem, WV
  • NPI 1215975438
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1023423613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "SALEM",
            "state": "WV",
            "postal_code": "264260392",
            "telephone_number": "304-782-2000",
            "fax_number": "304-782-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 W MAIN ST",
            "address_2": "STE 102",
            "city": "SALEM",
            "state": "WV",
            "postal_code": "264267515",
            "telephone_number": "304-782-2000",
            "fax_number": "304-782-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENFOLD",
        "first_name": "ADAM",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY STATE LICENSE",
            "identifier": "2610",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apenfold37634@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2373 W Main St Ste 102",
            "city": "Salem",
            "state": "WV",
            "country_code": "US",
            "postal_code": "264267515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Mae Moore
• Ladonna M Morrow
• Houda Mouradian- Al Tawil, MD
• Deborah A Ornstein
• Brittany Peck
• Olivia M Phillips
• Barbara Lee Pierce
• Elizabeth M Pigg, REGISTERED NURSE
• Shawna Pignanelli
• Amber J Price

• Medical Physician Assistant in Salem, WV
• Providers in Salem, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.