Cameron Community Health Center Inc
Organization Active NPI Family Medicine Physician · Cameron, WV
NPI 1396836367 · NPPES record last updated Aug 19, 2013
Key facts
- NPI
- 1396836367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CAMERON COMMUNITY HEALTH CENTER INC
- Practice address
- Rd# 4 Box 19 Wilson Drive
Cameron Community Health Center Inc
Cameron, WV 26033-9520 - Phone
- (304) 686-3376
- Fax
- (304) 686-3646
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Jay E Prager
- Title
- Ceo
- Phone
- (304) 843-3235
Practitioners 3
-
Kelly H Barki, DO
-
Kelly Ann Robinson, PA-C
-
Katrina Wasmuth, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111117000084 | WV | Part B Supplier - Clinic/Group Practice | 6709050321 |
Receives reassigned benefits from 3 practitioners Practice locations: Cameron, WV |
National Provider Directory
Locations
18 Wilson Dr
Cameron, WV 26033
Phone (304) 686-3376
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
Rd# 4 Box 19 Wilson Drive
Cameron Community Health Center Inc
Cameron, WV 26033-9520
Mailing address
Rd# 4 Box 19 Wilson Drive
Cameron, WV 26033-9520
Phone (304) 686-3376
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001709737 | Other | WV | BC/BS |
| 0008245000 | Medicaid | WV |
Other providers in Cameron, WV
- Kylea J Angel
- Kelly H Barki
- Deidre Marie Butler
- Jack Cain
- Cameron Drug Store, Inc
- Cameron Nursing & Rehabilitation Center LLC
- Cameron SNF LLC
- Cameron Volunteer Emergency Squad Inc
- Laken Donielle Chambers
All providers in Cameron, WV · Family Medicine Physician 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 Aug 19, 2013. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.