NORTH FORK PRIMARY CARE CLINIC
NPI 1346442134
Clinical Medical Laboratory in Riverton, WV

Active since June 04, 2007CLIA 51D0661868 · Microscopy
16921 MOUNTAINEER DRIVE, RIVERTON, WV 26814(304) 567-2101(304) 567-2102 Get Directions Write a Review

NPPES record last updated: July 19, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About North Fork Primary Care Clinic NPPES

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

NORTH FORK PRIMARY CARE CLINIC (NPI 1346442134) is a healthcare organization registered as a clinical medical laboratory in Riverton, West Virginia and active in the NPI registry since June 2007. The organization holds a CLIA Microscopy certificate valid through June 6, 2027 and lists Jamie Hudson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1346442134
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NamePENDLETON COMMUNITY CARE, INC.
Location Address16921 MOUNTAINEER DRIVERiverton, WV 26814-0101
Mailing AddressPo Box 101Riverton, WV 26814-0101 · (304) 567-2101 · Fax (304) 567-2102
Fax(304) 567-2102
Organization SubpartNo
Authorized OfficialJamie HudsonCeo · (304) 358-7230
Enumeration DateJune 4, 2007
Last NPPES UpdateJuly 19, 2016
✔ NPI 1346442134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License✔ Licensed in WV · 51D0661868
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
16921 MOUNTAINEER DRIVE, Riverton, WV 26814

Other Names 1

Doing Business AsNorth Fork Primary Care Clinic

Other Identifiers 2

Medicare PIN5118821WV
Medicaid3810006211WV

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

North Fork Primary Care Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

22

Medicare enrollment records show 22 clinicians reassign Medicare billing to North Fork Primary Care Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Diagnostic Radiology11
Nurse Practitioner6
Family Practice3
Clinical Psychologist1
Clinical Social Worker1

Nearest to this location (20)

See all 22
Nurse Practitioner
NPI 1902154644
16921 MOUNTAINEER DRIVE
Riverton, WV 26814
(304) 567-2101
✔ PECOSSame address
Nurse Practitioner
NPI 1013492263
82 PINE STREET
Franklin, WV 26807
(304) 358-2355
✔ PECOS9.3 mi
Clinical Psychologist
NPI 1972009405
82 PINE ST.
Franklin, WV 26807
(304) 358-2355
✔ PECOS9.3 mi
Nurse Practitioner
NPI 1174021604
82 PINE ST
Franklin, WV 26807
(304) 358-2355
✔ PECOS9.3 mi
Family Practice
NPI 1124604129
82 PINE ST
Franklin, WV 26807
(304) 358-2355
✔ PECOS9.3 mi
Clinical Social Worker
NPI 1912247917
82 PINE ST
Franklin, WV 26807
(304) 358-2355
✔ PECOS✔ Accepts Medicare9.3 mi
Family Practice
NPI 1649485350
314 PINE STREET
Franklin, WV 26807
(304) 358-2355
✔ PECOS9.3 mi
Family Practice
NPI 1245204015
314 PINE STREET
Franklin, WV 26807
(304) 358-2355
✔ PECOS9.3 mi
Nurse Practitioner
NPI 1588321327
314 PINE ST
Franklin, WV 26807
(304) 358-2355
✔ PECOS11 mi
Nurse Practitioner
NPI 1801435359
15 MOTT ST
Harman, WV 26270
(304) 227-4134
✔ PECOS13 mi
Nurse Practitioner
NPI 1417147091
65 HOSPITAL DR # 105
Petersburg, WV 26847
(304) 257-4340
✔ PECOS23 mi
Diagnostic Radiology
NPI 1881693935
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1801846399
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1750380804
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1275581076
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1629077672
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1982603932
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1538168562
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS62 mi
Diagnostic Radiology
NPI 1558360511
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
Diagnostic Radiology
NPI 1255330213
700 VILLAGE DR
Fairmont, WV 26554
(304) 366-2600
✔ PECOS✔ Accepts Medicare62 mi
See all 22 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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) 51D0661868

North Fork Primary Care · Riverton, WV
Active · expires Jun 6, 2027
CLIA Number51D0661868
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 7, 2025
Certificate Expiration DateJune 6, 2027
Laboratory DirectorMs. Mary Ellen Wimer
Laboratory Phone(304) 567-2101
Laboratory LocationNorth Fork Primary Care16921 Mountaineer Drive, Riverton, WV 26814
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pendleton Community Care, Inc.'s NPI number?

The NPI number for Pendleton Community Care, Inc. is 1346442134. It was assigned to this organization in the NPPES registry on June 4, 2007. The provider is doing business as North Fork Primary Care Clinic.

Where is Pendleton Community Care, Inc. located?

Pendleton Community Care, Inc. is located at 16921 Mountaineer Drive, Riverton, WV 26814. The listed phone number is (304) 567-2101.

What is Pendleton Community Care, Inc.'s specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Is Pendleton Community Care, Inc. enrolled in Medicare?

Yes. Pendleton Community Care, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pendleton Community Care, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 5 Medicare specialties reassign their Medicare billing to Pendleton Community Care, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (11), Nurse Practitioner (6) and Family Practice (3). Of these, 1 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pendleton Community Care, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 51D0661868) is associated with this NPI, valid through June 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pendleton Community Care, Inc. was last updated on July 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.