Westmoreland Family Care Center, Inc
Organization Active NPI Family Medicine Physician · Mason, WV
NPI 1497965461 · NPPES record last updated Mar 18, 2024
Key facts
- NPI
- 1497965461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1070 (WV)
- Legal business name
- WESTMORELAND FAMILY CARE CENTER, INC
- Practice address
- 16 2ND St
Mason, WV 25260-9677 - Phone
- (304) 773-5333
- Fax
- (304) 773-5885
- NPI assigned
- May 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Danny Ray Westmoreland, DO
- Title
- President
- Phone
- (304) 773-5333
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0673845 | Westmoreland Family Care Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090609000101 | WV | Part B Supplier - Clinic/Group Practice | 7618027939 |
Receives reassigned benefits from 1 practitioner Practice locations: Mason, WV |
National Provider Directory
Locations
16 2nd St
Mason, WV 25260
Phone (304) 773-5333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 1070 | WV | Yes |
Addresses
Primary practice location
16 2ND St
Mason, WV 25260-9677
Mailing address
16 2ND St
Mason, WV 25260-9677
Phone (304) 773-5333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0639572 | Medicaid | OH | |
| 0040703000 | Medicaid | WV |
Other providers in Mason, WV
- Robert G Tayengco
- Earnest Leon Trent Jr.
- Wal-Mart Stores East LP
- Anna Nicole Walker
- Deborah Wallen
- Danny Ray Westmoreland
All providers in Mason, 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 Mar 18, 2024. 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.
- 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.