Individual provider Active NPI

Zachary C Fairbanks, PA-C

  • Physician Assistant
  • Glen Dale, WV
National Provider Identifier
1841840840
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
815 Issued in WV
Practice address
800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone
(304) 845-3211
NPI assigned
Sep 12, 2019
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 815 WV Primary

Addresses

Primary practice location

800 Wheeling Ave
Glen Dale, WV 26038-1660

Mailing address

6 Hillcrest Dr
Martins Ferry, OH 43935-1018

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address zfairbanks149533@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address zfairbanks149533@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address zfairbanks149533@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address zfairbanks149533@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200115001898 WV Practitioner - Physician Assistant 7012342363 Reassigns benefits to 2 organizations
I20211004001559 OH Practitioner - Physician Assistant 7012342363

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reynolds Memorial Hospital, IncGroup PAC ID 9830184530, 152 clinicians

Practice addresses (Care Compare)

800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone (304) 843-3307

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reynolds Memorial Hospital, Inc. CurrentSince Nov 4, 2022 Accepting new patients
Fayette Physician Network Inc CurrentSince Dec 7, 2022 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

Interoperability endpoints

  • Direct secure messaging: zfairbanks149533@direct.wvuhsdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1841840840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HILLCREST DR",
            "city": "MARTINS FERRY",
            "state": "OH",
            "postal_code": "439351018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381660",
            "telephone_number": "304-845-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "ZACHARY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zfairbanks149533@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zfairbanks149533@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zfairbanks149533@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zfairbanks149533@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Dale, WV

Sources for this page

Verify at the official NPI Registry.