Mountaineer Accountable Care

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

MOUNTAINEER ACCOUNTABLE CARE

Practice address

RT 79 114 Bern Drive
Dawes, WV 25054-0070

Phone

(304) 734-2040

Fax

(304) 734-2047

NPI assigned

Apr 3, 2012

Last updated

Apr 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Craig Hall Robinson, MPH

Title

Executive Director

Phone

(304) 734-2040

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1902162092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "DAWES",
            "state": "WV",
            "postal_code": "250540070",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RT 79 114 BERN DRIVE",
            "city": "DAWES",
            "state": "WV",
            "postal_code": "250540070",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER ACCOUNTABLE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "HALL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-734-2040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles H.M. Jacques, M.D.
• Stephanie Marie Lusk, FNP-BC
• Brooke McCoy, MSN, APRN, FNP-BC
• Hannah McDermitt
• Jacob Mills
• Megan Olish-Terry, PA-C
• Dannel Karl Petgrave, PHD
• Ashley Portz, PAC
• Allison Nicole Pozega
• Alexandra Ritchie

• Community Health Clinic/Center in Dawes, WV
• Providers in Dawes, WV by specialty
• Community Health Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.