Laura Evelyn Abbott, DDS
Individual provider Active NPI Dentist · Green Bank, WV
NPI 1093061608 · NPPES record last updated Aug 25, 2022
Key facts
- NPI
- 1093061608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4000 (WV)
- Practice address
- 6404 Potomac Highland Trail
Green Bank, WV 24944-6404 - Phone
- (304) 456-5433
- Fax
- (304) 456-5439
- NPI assigned
- Aug 1, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 48
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121211000351 | WV | Practitioner - Dentist |
4082866470 | Reassigns benefits to 25 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4000 | WV | MD | Dentist |
Practice roles
Locations
250 Worthington Dr
Bridgeport, WV 26330
Phone (304) 326-7060
16 College Ave
Buckhannon, WV 26201
Phone (304) 472-3310
50 Bu Dr
Buckhannon, WV 26201
Phone (304) 472-8333
228 Kanawha Ave
Burnsville, WV 26335
Phone (304) 713-3105
1 Eagle Way
#C
Clarksburg, WV 26301
443 Lee Ave
Clarksburg, WV 26301
Phone (304) 326-7420
271 Warrior Way
Dunmore, WV 24934
Phone (304) 799-0515
142 Flatwoods Corner Rd
Flatwoods, WV 26621
Phone (304) 402-2023
113 5th St
Gassaway, WV 26624
Phone (304) 364-5867
6536 Main St
Jane Lew, WV 26378
Phone (304) 884-2307
926 5th Ave
Ste A
Marlinton, WV 24954
Phone (304) 799-4916
1302 Buckhannon Pike
Nutter Fort, WV 26301
Phone (304) 326-7501
1176 Oil Creek Rd
Roanoke, WV 26447
Phone (304) 452-0001
200 Tetrick Rd
Shinnston, WV 26431
Phone (304) 326-7280
288 N Hill Rd
Sutton, WV 26601
Phone (304) 402-2105
100 Carter Braxton Dr
Sutton, WV 26601
Phone (304) 765-2644
249 Skidmore Ln
Sutton, WV 26601
Phone (304) 317-7275
200 Jerry Burton Dr
Sutton, WV 26601
Phone (304) 765-7331
182 School St
West Milford, WV 26451
Phone (304) 745-5739
358 Court Ave
Weston, WV 26452
Phone (304) 269-0041
509 Berlin Rd
Weston, WV 26452
Phone (304) 269-0029
Interoperability endpoints
- laura.abbott.1@4803.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4000 | WV | Yes |
Addresses
Primary practice location
6404 Potomac Highland Trail
Green Bank, WV 24944-6404
Mailing address
6404 Potomac Highland Trail
Green Bank, WV 24944-6404
Phone (304) 456-5433
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4000 | Other | WV | WV STATE LICENSE |
Other names
- Laura Evelyn Ellars
Other providers in Green Bank, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.