Yahweh Medical Clinic PSC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

YAHWEH MEDICAL CLINIC PSC

Doing business as

Yahweh Medical Clinic PSC

Practice address

3513 Cumberland Ave
Middlesboro, KY 40965-2611

Phone

(631) 790-2862

NPI assigned

Jul 24, 2019

Last updated

Sep 19, 2019By 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

Asher Gabriel, MDNPI 1588864326

Title

Owner

Phone

(631) 790-2862

Specialties & licenses 2

Addresses

Other names 1

• YAHWEH MEDICAL CLINIC PSC Doing business as

Electronic endpoints 1

Practitioners 1

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.

• Asher Gabriel, MD

  • General Practice Physician
  • Pennington Gap, VA
  • NPI 1588864326
  Authorized official Same address or phone

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1497309827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3589 HIGHWAY 33 S",
            "city": "NEW TAZEWELL",
            "state": "TN",
            "postal_code": "378252319",
            "telephone_number": "631-790-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3513 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652611",
            "telephone_number": "631-790-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAHWEH MEDICAL CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ASHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-790-2862",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Office",
            "affiliation": "N",
            "endpointDescription": "Office address",
            "address_1": "3513 Cumberland Ave",
            "city": "Middlesboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "409652611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "YAHWEH MEDICAL CLINIC PSC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YAHWEH MEDICAL CLINIC PSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cora Ann Willis-King, MA
• Bruce Taylor Wilson, D.M.D.
• Nancy Wilson
• Deborah Witherington
• Christal Michelle Woody, APRN

• General Practice Physician in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.