Womencare Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Dunbar, WV
NPI 1578073706 · NPPES record last updated May 24, 2022
Key facts
- NPI
- 1578073706
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 23481875 (WV)
- Legal business name
- WOMENCARE INC
- Practice address
- 301 Washington Ave
Dunbar, WV 25064-3420 - Phone
- (304) 757-6999
- Fax
- (304) 201-5019
- NPI assigned
- Oct 2, 2017
- Organization subpart
- No
Authorized official
- Name
- Julie Dianne Ray
- Title
- Credentialing Specialist
- Phone
- (304) 757-6999
Owners & managing parties with NPI records 18
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 18
Corporate family (same tax ID) 27
Facilities with the same owner 4
Practitioners 102
-
Amber Louise Bell, APRN FNP-C
-
Tanya Renee Call, FNP
-
Erica R Frye, PA
-
Curtis Kevin Grant, FNP-BC
-
Rhoda Hamilton, FNP
-
Trena Kish, FNP
-
Sarah Dawn Knight, F.N.P.-B.C.
-
Morgan McClung, FNP-BC
-
Stephanie Dawn Metz, FNP-BC
-
Taucha Lynn Miller, MSN, FNP-BC
-
Rachael D. Mitchell, PA-C
-
Leon Ronen, MD
-
Carla Saunders, PA-C
-
Breann Hawley Thomas, WHNP-BC
-
Tonya Vannatter, LGSW
-
Crystal White, FNP
-
Tawna Farley White, APRN, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Federally qualified health center certification: CCN 511135
- Legal name
- WOMENCARE INC
- Doing business as
- FAMILYCARE HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 10, 2017
- Last certification
- Nov 10, 2017
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 2, 1989 in WV
- Enrollment address
- 301 Washington Ave
Dunbar, WV 25064-3420
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Bonnie J Ohara |
Corporate Director |
Apr 24, 2017 | |
| Steven E Cunningham |
Corporate Officer | Oct 1, 2002 | |
| Kelsey Clough |
Corporate Officer | Jun 28, 2021 | |
| Alfreda B Perry Dean |
Corporate Director |
Jan 23, 2006 | |
| Rebecca Ratliff |
Corporate Director |
Dec 21, 2015 | |
| Womencare Inc |
Operational/Managerial Control | Nov 1, 2017 | |
| David Bumgarner |
Corporate Officer | May 1, 2020 | |
| Christopher Carew |
Corporate Officer | May 18, 2020 | |
| Susan C Scouras |
Corporate Director |
Sep 24, 2007 | |
| Julie a Pratt |
Corporate Director |
Apr 24, 2017 | |
| Craig Glover |
Corporate Officer |
Feb 11, 2019 | |
| W-2 Managing Employee |
Feb 11, 2019 | ||
| Operational/Managerial Control |
Feb 11, 2019 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Family Care Health Center |
Federally qualified health center | Operational/Managerial Control | Aug 15, 2011 |
| Familycare Health Center |
Federally qualified health center | Operational/Managerial Control | Jun 2, 1989 |
| Familycare |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Familycare Healthcenter |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171221000836 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 4587568134 | Practice locations: Dunbar, WV |
| O20180312001821 | WV | Part B Supplier - Clinic/Group Practice | 4587568134 |
Receives reassigned benefits from 46 practitioners Practice locations: Dunbar, WV |
National Provider Directory
- Tax ID family
- Womencare Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 23481875 | WV | Yes |
Addresses
Primary practice location
301 Washington Ave
Dunbar, WV 25064-3420
Mailing address
97 Great Teays Blvd Ste 6
Scott Depot, WV 25560-9816
Phone (304) 757-6999
Other names
- Familycare Health Center
NPI Registry JSON
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653350400000",
"number": "1578073706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 GREAT TEAYS BLVD STE 6",
"city": "SCOTT DEPOT",
"state": "WV",
"postal_code": "255609816",
"telephone_number": "304-757-6999",
"fax_number": "304-201-5019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 WASHINGTON AVE",
"city": "DUNBAR",
"state": "WV",
"postal_code": "250643420",
"telephone_number": "304-757-6999",
"fax_number": "304-201-5019"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOMENCARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-02",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A",
"authorized_official_last_name": "RAY",
"authorized_official_first_name": "JULIE",
"authorized_official_middle_name": "DIANNE",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "304-757-6999"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "WV",
"license": "23481875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Familycare Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dunbar, WV
- Kacey Marie Wilson
- Allison Marie Wise
- Angel Withrow
- Mathew Withrow
- Vanessa Wolfe
- Wvsu Metro Area Agency on Aging
All providers in Dunbar, WV · Federally Qualified Health Center (FQHC) 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 May 24, 2022. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.