Greene Skin and Wellness

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

GREENE SKIN AND WELLNESS

Practice address

40 Shae Ave Ste a
Chapmanville, WV 25508-9805

Phone

(304) 310-2261

Fax

(304) 310-2262

NPI assigned

Sep 25, 2023

Organization subpart

No

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

Authorized official

Name

Wendy White

Title

Credentialing Specialist

Phone

(304) 688-7027

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corey Edward Greene, PAC

  • Physician Assistant
  • Chapmanville, WV
  • NPI 1174828867
  Medicare reassignment

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1225817802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "DAVIN",
            "state": "WV",
            "postal_code": "256170445",
            "telephone_number": "304-310-2261",
            "fax_number": "304-310-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SHAE AVE STE A",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255089805",
            "telephone_number": "304-310-2261",
            "fax_number": "304-310-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE SKIN AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "304-688-7027"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia D Gattuso, DC
• Stephanie Diane George
• Summer Ghee
• Jacob Gibson
• Victoria Lynn Gore
• Corey Edward Greene, PAC
• Joyce Marie Gullett
• Laura Hamilton
• Brittney Hartman
• Tonya Hatfield

• Physician Assistant in Chapmanville, WV
• Providers in Chapmanville, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.