Active NPI
Cornerstone Health Care Inc
- Family Medicine Physician
- Parkersburg, WV
National Provider Identifier
1790834018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01272
- Legal business name
- CORNERSTONE HEALTH CARE INC
- Practice address
- 2601 Dudley Ave
Parkersburg, WV 26101-2649 - Phone
- (304) 422-9156
- Fax
- (304) 422-9159
- NPI assigned
- Jan 9, 2007
- Organization subpart
- Yes
- Parent organization
- CORNERSTONE HEALTH CARE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vicki L Lyons
- Title
- Office Manager
- Phone
- (304) 424-4129
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01272 | WV | Primary |
Addresses
Primary practice location
2601 Dudley Ave
Parkersburg, WV 26101-2649
Mailing address
2601 Dudley Ave
Parkersburg, WV 26101-2649
Phone (304) 422-9156
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2002102 | Medicaid | OH | |
| 001710672 | Other | BLUE CROSS BLUE SHIELD | |
| CD5906 | Other | RAILROAD MEDICARE GROUP NUMBER | |
| 0010309000 | Medicaid | WV |
National Provider Directory
National Provider Directory- Part of
- Cornerstone Health Care Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209427200000",
"number": "1790834018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 DUDLEY AVE",
"city": "PARKERSBURG",
"state": "WV",
"postal_code": "261012649",
"telephone_number": "304-422-9156",
"fax_number": "304-422-9159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 DUDLEY AVE",
"city": "PARKERSBURG",
"state": "WV",
"postal_code": "261012649",
"telephone_number": "304-422-9156",
"fax_number": "304-422-9159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORNERSTONE HEALTH CARE INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CORNERSTONE HEALTH CARE",
"enumeration_date": "2007-01-09",
"last_updated": "2008-04-29",
"status": "A",
"authorized_official_last_name": "LYONS",
"authorized_official_first_name": "VICKI",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "304-424-4129"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "WV",
"license": "01272",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2002102",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "001710672",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP NUMBER",
"identifier": "CD5906",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0010309000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Parkersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.