Organization Active NPI

Cornerstone Medical Group of West Virginia LLC

  • Family Medicine Physician
  • Green Bank, WV
National Provider Identifier
1811877442
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORNERSTONE MEDICAL GROUP OF WEST VIRGINIA LLC
Practice address
4914 Potomac Highlands TRL
Green Bank, WV 24944-8507
Phone
(681) 535-2277
Fax
(740) 619-7029
NPI assigned
Sep 4, 2025
Last updated
Feb 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Jeri Sue ThomasNPI 1881920387
Title
Nurse Practitioner/Owner
Phone
(740) 590-1181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4914 Potomac Highlands TRL
Green Bank, WV 24944-8507

Mailing address

27799 State Route 7
Cheshire, OH 45620-9603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260107004187 WV Part B Supplier - Clinic/Group Practice 1153807375 Receives reassigned benefits from 1 practitioner
Practice locations: Charleston, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2339273Cornerstone Medical Group of West Virginia, LLC4914 Potomac Highlands Trail, Green Bank, WV 24944Certificate of waiverFeb 25, 2028

National Provider Directory

National Provider Directory

Locations

428 Leon Sullivan Way
Charleston, WV 25301
Phone (304) 409-8128

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1811877442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27799 STATE ROUTE 7",
            "city": "CHESHIRE",
            "state": "OH",
            "postal_code": "456209603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 POTOMAC HIGHLANDS TRL",
            "city": "GREEN BANK",
            "state": "WV",
            "postal_code": "249448507",
            "telephone_number": "681-535-2277",
            "fax_number": "740-619-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE MEDICAL GROUP OF WEST VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JERI",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "740-590-1181"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bank, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.