Rainbow Pediatrics, Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

23655 Issued in WV

Legal business name

RAINBOW PEDIATRICS, INC

Practice address

354 Commerce Dr
Beaver, WV 25813-8985

Phone

(304) 250-0150

Fax

(304) 250-0153

NPI assigned

Sep 23, 2014

Last updated

Oct 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John P. Fernald, M.D.NPI 1730150251

Title

President

Phone

(304) 250-0150

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Patrick Fernald, MD

  • Pediatrics Physician
  • Beaver, WV
  • NPI 1730150251
  Medicare reassignment NPD Authorized official
• Kelly Lynn Legg, FNP-BC

  • Family Nurse Practitioner
  • Beaver, WV
  • NPI 1588091706
  NPD (past)
• Brittany Lynn Miller, FNP-BC

  • Nurse Practitioner
  • Beaver, WV
  • NPI 1114571668
  NPD (past)
• Rebecca Dawn Ross, APRN FNP-BC

  • Family Nurse Practitioner
  • Morgantown, WV
  • NPI 1063929941
  NPD (past)

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1215339098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 STANAFORD RD STE 208",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258018624",
            "telephone_number": "304-250-0150",
            "fax_number": "304-250-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 COMMERCE DR",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258138985",
            "telephone_number": "304-250-0150",
            "fax_number": "304-250-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW PEDIATRICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "FERNALD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-250-0150",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "23655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Powerback Rehabilitation LLC (Powerback Rehabilitation)
• Prime Health Associates (Beaver Family Clinic)
• Proactive Health and Physical Therapy LLC
• Cynthia Pugh, LICSW
• Matthew Shane Ragland
• Timothy Reynolds
• Danielle Richmond
• Shawna Kristyne Richmond, PHARMD
• Ashley Nichole Roberts
• Elizabeth Roberts, LGSW

• Pediatrics Physician in Beaver, WV
• Providers in Beaver, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.