NPIMap

Individual provider Active NPI

Hannah Rebekah Prontiker, PA-C

  • Physician Assistant
  • Peterstown, WV
National Provider Identifier
1265006902
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
862 Issued in WV
Practice address
3115 Seneca TRL S
Peterstown, WV 24963-5040
Phone
(304) 753-9100
Fax
(304) 753-9353
NPI assigned
May 17, 2021
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 862 WV Primary

Addresses

Primary practice location

3115 Seneca TRL S
Peterstown, WV 24963-5040

Mailing address

3115 Seneca TRL S
Peterstown, WV 24963-5040
Phone (304) 753-9100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hannah.prontiker@camc.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825001599 WV Practitioner - Physician Assistant 2163827460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1521 Maplewood Ave
Ronceverte, WV 24970-8026
Phone (304) 647-5642

3115 Seneca TRL S
Peterstown, WV 24963-5040
Phone (304) 753-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2463WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Camc Greenbrier Valley Medical Center Inc CurrentSince Dec 1, 2024 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. Past Accepting new patients

Locations

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

1521 Maplewood Ave
Ronceverte, WV 24970

Interoperability endpoints

  • Direct secure messaging: aganesh@bcp-wv.direct.office.nextgen.com
  • Direct secure messaging: hannah.prontiker@camc.cernerdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1265006902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 SENECA TRL S",
            "city": "PETERSTOWN",
            "state": "WV",
            "postal_code": "249635040",
            "telephone_number": "304-753-9100",
            "fax_number": "304-753-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 SENECA TRL S",
            "city": "PETERSTOWN",
            "state": "WV",
            "postal_code": "249635040",
            "telephone_number": "304-753-9100",
            "fax_number": "304-753-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRONTIKER",
        "first_name": "HANNAH",
        "middle_name": "REBEKAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hannah.prontiker@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3115 Seneca Trl S",
            "city": "Peterstown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "249635040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peterstown, WV

Sources for this page

Verify at the official NPI Registry.