Leo Pantilla Pajarillo, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

11772 Issued in WV

Practice address

186 E 2ND Ave Ste 100
Williamson, WV 25661-3602

Phone

(304) 236-5902

NPI assigned

Apr 18, 2007

Last updated

Jan 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Williamson Health & Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1467711150
  Medicare reassignment NPD
• Williamson Memorial, Inc.

  • General Acute Care Hospital
  • Williamson, WV
  • NPI 1013521228
  Medicare reassignment NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center-Mingo Central High School

  • Federally Qualified Health Center (FQHC)
  • Delbarton, WV
  • NPI 1225684731
  NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center - Alderson Clinic

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1700445798
  NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center -Licensed Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williamson, WV
  • NPI 1942840384
  NPD
• Williamson Health & Wellness Center, Inc

  dba Williamson Health & Wellness Center-Pediatric Clinic

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1902404395

  Pediatrics

  NPD
• Williamson Memorial, Inc.

  • Emergency Medicine Physician
  • Williamson, WV
  • NPI 1174345243
  NPD

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1497971212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612080",
            "telephone_number": "304-236-5902",
            "fax_number": "304-235-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 E 2ND AVE STE 100",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613602",
            "telephone_number": "304-236-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJARILLO",
        "first_name": "LEO",
        "middle_name": "PANTILLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "11772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64698426",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112030000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ohio Valley Physicians Inc (OVP Health)
• Ohio Valley Physicians Inc (OVP Health)
• Sam C Olive Jr., DDS
• Cheyanna Aaron Oneal
• Linda Renae Pack
• Faith Elizabeth Parsley
• Samuel Jonathan Patrick
• Jessica Ann Payne
• Kendra Marie Pegg, BA
• Angela Darlene Perkins

• General Practice Physician in Williamson, WV
• Providers in Williamson, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.