Sidney Jerome Cline, APRN
Individual provider Active NPI Family Nurse Practitioner · Logan, WV
NPI 1255748166 · NPPES record last updated Jul 2, 2021
Key facts
- NPI
- 1255748166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN75819NP (WV)
- Practice address
- 122 Nick Savas Dr
Logan, WV 25601-3468 - Phone
- (304) 752-8081
- Fax
- (304) 752-8083
- NPI assigned
- Jul 14, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 26
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lincoln County Primary Care Center Inc
Practice addresses (Care Compare)
1563 Sand Plant Rd
South Charleston, WV 25309-6120
Phone (304) 756-1500
471 Main St
Madison, WV 25130-1223
Phone (304) 369-5170
Hospital & facility affiliations
- Dignity Home Health
- Logan Regional Medical Center
- Tug Valley Arh Regional Medical Center
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: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150121000732 | WV | Practitioner - Nurse Practitioner | 0244554368 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN75819NP | WV | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln County Primary Care Center, Inc. | Current |
Accepting new patients | |
| Lincoln County Primary Care Center, Inc. | Current | Accepting new patients | |
| Lincoln County Primary Care Center Inc | Current |
Accepting new patients | |
| Madison Medical, PLLC | Current | Accepting new patients | |
| Lincoln County Primary Care Center, Inc. | Current | Accepting new patients | |
| Lincoln County Primary Care Center, Inc. | Current |
Accepting new patients | |
| Lincoln County Primary Care Center, Inc. | Current | Accepting new patients | |
| Lincoln County Primary Care Center, Inc. | Current | Accepting new patients | |
| Lincoln County Primary Care Center, Inc | Current |
Accepting new patients | |
| Lincoln County Primary Care Center, Inc | Current | Accepting new patients | |
| Lincoln County Primary Care Center, Inc | Past | Accepting new patients |
Locations
5322 McClellan Hwy
Branchland, WV 25506
Phone (304) 824-5707
7400 Lynn Ave
Hamlin, WV 25523
122 Nick Savas Dr
Logan, WV 25601
Phone (304) 752-8081
471 Main St
Madison, WV 25130
Phone (304) 369-5170
650 E McDonald Ave
Man, WV 25635
Phone (304) 583-8585
600 E McDonald Ave
Man, WV 25635
Phone (304) 583-6541
1563 Sand Plant Rd
South Charleston, WV 25309
Phone (304) 756-1500
Interoperability endpoints
- sidney.cline.1@6401.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN75819NP | WV | Yes |
Addresses
Primary practice location
122 Nick Savas Dr
Logan, WV 25601-3468
Mailing address
7400 Lynn Ave
Hamlin, WV 25523-1138
Phone (304) 824-5806
Other practice location 1
184 E 2nd Ave
Ste 210
Williamson, WV 25661-3602
Phone (304) 236-5902
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APRN75819NP | Other | WV | STATE LICENSE |
Other names
- Jerome Cline
Other providers in Logan, WV
- Michael Shawn Cheek
- Sherry Church
- Jodi M Cisco-Goff
- Skyler Reed Clemons
- Bethony Jill Click
- Tabatha Cline
- Martin L. Codispoti
- Marcus Steven Coleman
- Wendy Coleman
- Heather Villa Colley
All providers in Logan, WV · Family Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2021. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.