David Wayne Runyon, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

838 Issued in WV

Practice address

415 Carriage Drive
Beckley, WV 25801

Phone

(304) 250-0142

Fax

(304) 253-7262

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern West Virginia Primary Care IncGroup PAC ID 9830408376, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern West Virginia Primary Care Inc

  • Primary Care Clinic/Center
  • Beckley, WV
  • NPI 1598147431
  Medicare reassignment Care Compare group
• Beckley Area Surgical Associates PLLC

  • Surgery Physician
  • Beckley, WV
  • NPI 1265481220
  NPD (past)
• Lumen Dermatology LLC

  • Dermatology Physician
  • Lady Lake, FL
  • NPI 1235938341
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1518964238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 CARRIAGE DRIVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "25801",
            "telephone_number": "304-250-0142",
            "fax_number": "304-253-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CARRIAGE DRIVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "25801",
            "telephone_number": "304-250-0142",
            "fax_number": "304-253-7262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Buenos Aires Blvd",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321598974",
            "country_code": "US",
            "telephone_number": "352-750-6946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8750 SW Highway 200 Ste 102",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344817810",
            "country_code": "US",
            "telephone_number": "352-732-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNYON",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "838",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9109546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022138600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IQ891Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rayvon Eric Rowe
• Jamie Ruth Rudisill, PHARMD
• David Lowell Rumberg
• Jessica Marie Runion
• Bailey Runyon
• Jennifer Lynn Runyon
• Larry N Rupe, CRNA
• Andrea Ruppenthal
• Rural Acres Infusion, LLC
• Megan Rachel Rutherford

• Surgical Physician Assistant in Beckley, WV
• Providers in Beckley, WV by specialty
• Surgical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.