Jayne Ladier Canterbury, D.O.
Individual provider Active NPI Family Medicine Physician · Peterstown, WV
NPI 1760433254 · NPPES record last updated Jan 29, 2025
Key facts
- NPI
- 1760433254
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1562 (WV)
- Practice address
- 2869 Seneca TRL S
Peterstown, WV 24963-5037 - Phone
- (304) 753-4336
- Fax
- (304) 772-5553
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Monroe County Health Center Board of Trustees
Practice addresses (Care Compare)
PO Box
Suite 590
Union, WV 24983
Hospital & facility affiliations
- Adoration Home Health
- Princeton Community Hospital Assn Inc
- Carilion Giles Community Hospital
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040407000228 | WV | Practitioner - Family Practice | 7012900806 |
Reassigns benefits to 1 organization Practice locations: Union, WV |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1562 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monroe County Health Center Board of Trustees | Current |
Accepting new patients | |
| Monroe County Health Center Board of Trustees | Current | Accepting new patients | |
| Monroe County Health Center, Board of Trustees | Current |
Accepting new patients | |
| Monroe County Health Center Board of Trustees | Past | Accepting new patients | |
| Monroe County Health Center | Past | Accepting new patients |
Locations
142 James Monroe Dr
Lindside, WV 24951
Phone (304) 753-5940
200 Health Center Dr
Union, WV 24983
Phone (304) 772-3064
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1562 | WV | Yes |
Addresses
Primary practice location
2869 Seneca TRL S
Peterstown, WV 24963-5037
Mailing address
PO Box 590
Union, WV 24983-0590
Phone (304) 772-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00348473 | Other | WV | RAILROAD MEDICARE |
| 00190786 | Other | WV | BCBS MOUNTAIN STATE |
| 1802020000 | Medicaid | WV | |
| 172431 | Other | WV | UMWA |
| 5004699 | Other | WV | AETNA |
Other providers in Peterstown, WV
- Tara Nicole Blake
- Heather Lynn Bogenschutz
- Kandi Jo Boggs
- Kimberly Bowman
- Camc Greenbrier Valley Medical Center, Inc.
- Kayla Rose Carinelli-Fox
- Amanda Leigh Clark
- Mark A Clarkson
- Rachael Dawn Cody
- Amber Marie Collins
All providers in Peterstown, 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 Jan 29, 2025. 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).
- 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.