Mountaineer Healthcare, PLLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MOUNTAINEER HEALTHCARE, PLLC

Practice address

1500 Terrace St
Hinton, WV 25951

Phone

(304) 466-2933

Fax

(304) 466-2932

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rubina Tasneem Khan

Title

Office Manager

Phone

(304) 466-2933

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 513912

Legal name

MOUNTAINEER HEALTHCARE PLLC

Doing business as

MOUNTAINEER HEALTHCARE PLLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Oct 12, 2004

Last certification

Nov 22, 2022

Ownership / control type

1A

Organization structure

OtherProprietary

Incorporated

Nov 17, 2003 in WV

Enrollment address

83 Summers Hospital Road
Suite 105
Hinton, WV 25951-9752

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Waheed A Khan, MD

  • Internal Medicine Physician
  • Hinton, WV
  • NPI 1457319220

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michele Bailey

  • Family Nurse Practitioner
  • Hinton, WV
  • NPI 1841539509
  Medicare reassignment NPD
• Waheed A Khan, MD

  • Internal Medicine Physician
  • Hinton, WV
  • NPI 1457319220
  Medicare reassignment NPD
• Janet Rena Bryant, NP-C

  • Family Nurse Practitioner
  • Hinton, WV
  • NPI 1043632326
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1821145301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "address_2": "1500 TERRACE ST",
            "city": "HINTON",
            "state": "WV",
            "postal_code": "259510067",
            "telephone_number": "304-466-2933",
            "fax_number": "304-466-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 TERRACE ST",
            "city": "HINTON",
            "state": "WV",
            "postal_code": "25951",
            "telephone_number": "304-466-2933",
            "fax_number": "304-466-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "RUBINA",
        "authorized_official_middle_name": "TASNEEM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-466-2933",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda K Mills, LSW
• Crystal Elisabeth Mitchell, PA-C
• Tabitha Marie Mitchem
• Montera Health West Virginia LLC
• Michael T Montgomery, D.O.
• Jessica Lynn Neely
• Joanne Leona Nichols
• Connie Jo Northern
• Kelly Renee Northern
• Amy O'Brien

• Rural Health Clinic/Center in Hinton, WV
• Providers in Hinton, WV by specialty
• Rural Health Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.