Family Healthcare Associates Inc
Organization Active NPI Rural Health Clinic/Center · Man, WV
NPI 1902835010 · NPPES record last updated Jul 12, 2010
Key facts
- NPI
- 1902835010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 0015 (WV)
- Legal business name
- FAMILY HEALTHCARE ASSOCIATES INC
- Practice address
- 114 Main Street
Man, WV 25635-0114 - Phone
- (304) 583-0019
- Fax
- (304) 583-0016
- NPI assigned
- Jul 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Samuel A Muscari Sr., DO
- Title
- President
- Phone
- (304) 294-4880
Owners & managing parties with NPI records 4
-
Anthony R Flaim, DO
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 5
Practitioners 25
-
Anthony R Flaim, DO
-
Evan Muscari, DO
-
Joshua Tollison Bishop, PA-C
-
Connie Dale Cook II, PAC
-
Donna Flaim, PAC
-
Charles E Hill Jr., PAC
-
Jonathan L Karper, PAC
-
Kelli M Karper, PAC
-
Ashley Nicole Lovern, MSN, APRN, FNP-C
-
Julie Massey, FNP-C
-
Ashley Price, FNP-C
-
Jeffrey A Prichard, PAC
-
Jackie D Shorter, PAC
-
Leah Smith, FNP
-
Rachelle Lyle Stewart, PA-C
-
Rachel Leigh Stover, C-FNP
-
Michael Douglas Walker, PA-C
-
John D West, PA C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0979141 | Family Healthcare Assoc Inc | Certificate of waiver | Oct 15, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV
Rural health clinic certification: CCN 513900
- Legal name
- FAMILY HEALTHCARE ASSOCIATES INC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 28, 2000
- Last certification
- Apr 30, 2019
- Ownership / control type
- 1B
- Organization structure
- Corporation · Proprietary
- Incorporated
- Aug 11, 1986 in WV
- Enrollment address
- 114 Main Street
Man, WV 25635-0114
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Samuel Muscari |
5% Or Greater Direct Ownership Interest | Aug 11, 1986 | |
| General Partnership Interest | Aug 11, 1986 | ||
| Corporate Director | Aug 11, 1986 | ||
| Samuel Muscari |
5% Or Greater Direct Ownership Interest | Aug 11, 1986 | |
| General Partnership Interest | Aug 11, 1986 | ||
| Corporate Director | Aug 11, 1986 | ||
| Michael a Muscari |
5% Or Greater Direct Ownership Interest | Aug 11, 1986 | |
| General Partnership Interest | Aug 11, 1986 | ||
| Corporate Director | Aug 11, 1986 | ||
| Stephanie Sizemore |
W-2 Managing Employee | Jan 22, 2010 | |
| Anthony Flaim |
5% Or Greater Direct Ownership Interest | Aug 11, 1986 | |
| General Partnership Interest | Aug 11, 1986 | ||
| Corporate Director | Aug 11, 1986 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031210000848 | WV | Part B Supplier - Clinic/Group Practice | 8325957996 |
Receives reassigned benefits from 26 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Gilbert, WV; Man, WV; Mullens, WV; Oceana, WV; Pineville, WV; Welch, WV |
| O20100204000176 | WV | Part a Provider - Rural Health Clinic | 8325957996 | Practice locations: Man, WV |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | 0015 | WV | Yes |
Addresses
Primary practice location
114 Main Street
Man, WV 25635-0114
Mailing address
PO Box 1650
97 Main Ave
Pineville, WV 24874-1650
Phone (304) 732-6735
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5301010000 | Medicaid | WV | |
| FA9306624 | Other | STATE MEDICARE |
Other providers in Man, WV
- Terri D Doss
- Taylor Duncan
- Jonathan Matthew Ellis
- Wilson Gene Evans
- Faithful Works Homecare LLC
- Crystal Dawn Gibson
- Elizabeth Brook Hannah Gibson
- Stephanie Goble
- Shellia Jean Grimmett
- Holli Harvey
All providers in Man, WV · Rural Health Clinic/Center in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.