Jeffrey A Prichard, PAC
Individual provider Active NPI Family Medicine Physician · Pineville, WV
NPI 1508949595 · NPPES record last updated Feb 10, 2010
Key facts
- NPI
- 1508949595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 229 (WV)
- Practice address
- 1650 Main Street
Pineville, WV 24874 - Phone
- (304) 732-6735
- Fax
- (304) 732-9218
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100208000521 | WV | Practitioner - Physician Assistant | 7517000938 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 229 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare Associates Inc | Family Medicine | Current | Accepting new patients |
| Family Healthcare Associates Inc | Family Medicine | Current | Accepting new patients |
| Family Healthcare Associates Inc | Family Medicine | Current | Accepting new patients |
| Family Healthcare Associates Inc | Family Medicine | Current | Accepting new patients |
| Family Healthcare Associates Inc | Family Medicine | Current |
Accepting new patients |
Locations
114 Main St
Man, WV 25635
Phone (304) 583-0019
205 Howard Ave
Mullens, WV 25882
Phone (304) 294-4880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 229 | WV | Yes |
Addresses
Primary practice location
1650 Main Street
Pineville, WV 24874
Mailing address
PO Box 1650
Family Healthcare Assoc Inc
Pineville, WV 24874
Phone (304) 732-6735
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810000498 | Medicaid | WV |
Other providers in Pineville, WV
- Lisa Ann Orndorff
- Corey Paynter
- Pharmacare LLC
- Pharmacy Care Inc
- Praxis Corporation
- Christopher Craig Reed
- Ola Roberts
- Letha C Rocchi
- Angela May-Marie Schumacher
- Jackie D Shorter
All providers in Pineville, 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 Feb 10, 2010. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.