CAMDEN FAMILY DENTISTRY
NPI 1013590744
Clinic/Center - Federally Qualified Health Center (FQHC) in Summersville, WV

Q: What is Camden On Gauley Medical Center Inc's NPI number?

The NPI number for Camden On Gauley Medical Center Inc is 1013590744. It was assigned to this organization in the NPPES registry on April 30, 2021. The provider is doing business as Camden Family Dentistry.

Q: What is Camden On Gauley Medical Center Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since April 30, 2021CLIA 51D0017142 · Microscopy

415 MAIN ST, SUMMERSVILLE, WV 26651(304) 872-1663(304) 872-8104 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2024, Apr 30, 2021 (2 updates tracked since 2021).

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About Camden Family Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAMDEN FAMILY DENTISTRY (NPI 1013590744) is a healthcare organization registered as a federally qualified health center (fqhc) in Summersville, West Virginia and active in the NPI registry since April 2021. The organization holds a CLIA Microscopy certificate valid through July 12, 2027 and lists Margaret Hickey, Ceo, as its authorized official.

NPPES Registry Identity

NPI1013590744

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameCAMDEN ON GAULEY MEDICAL CENTER INC

Location Address415 MAIN STSummersville, WV 26651-1343

Mailing Address10003 Webster RdCamden On Gauley, WV 26208-7713 · (304) 872-1663 · Fax (304) 872-1663

Phone(304) 872-1663

Fax(304) 872-8104

Organization SubpartNo

Authorized OfficialMargaret HickeyCeo · (304) 226-5725

Enumeration DateApril 30, 2021

Last NPPES UpdateMay 8, 20242 updates tracked since enumeration

NPPES CertifiedMay 8, 2024

✔ NPI 1013590744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedClinic/Center · DentalTaxonomy 261QD0000X

415 MAIN ST, Summersville, WV 26651

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Other Names 1

Doing Business AsCamden Family Dentistry

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 51D0017142

Camden On Gauley Medical Center, Inc Dba Camden Family Health · Camden On Gauley, WV

Active · expires Jul 12, 2027

CLIA Number51D0017142

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateJuly 13, 2025

Certificate Expiration DateJuly 12, 2027

Laboratory DirectorElizabeth A. Coffman

Laboratory Phone(304) 226-5725

Laboratory LocationCamden On Gauley Medical Center, Inc Dba Camden Family Health10003 Webster Road, Camden On Gauley, WV 26208

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEITH RICHARD DE YOUNG M.D.

Family Medicine