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KANAWHA CITY HEALTH CENTER
NPI 1588908362
Clinic/Center - Federally Qualified Health Center (FQHC) in Charleston, WV

Active since November 19, 2012
4602 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 734-2040(304) 734-2047 Get Directions Write a Review

NPPES record last updated: November 19, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kanawha City Health Center NPPES

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

KANAWHA CITY HEALTH CENTER (NPI 1588908362) is a healthcare organization registered as a federally qualified health center (fqhc) in Charleston, West Virginia and active in the NPI registry since November 2012. The organization lists Jennifer Russell, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1588908362
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCABIN CREEK HEALTH CENTER, INC.
Location Address4602 MACCORKLE AVE SECharleston, WV 25304-1848
Mailing AddressPo Box 70Dawes, WV 25054-0070 · (304) 734-2040 · Fax (304) 734-2047
Phone(304) 734-2040
Fax(304) 734-2047
Organization SubpartNo
Authorized OfficialJennifer RussellAdministrative Assistant · (304) 734-2040
Enumeration DateNovember 19, 2012
✔ NPI 1588908362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in WV · 1041-6374
4602 MACCORKLE AVE SE, Charleston, WV 25304
Open in Google Maps ↗

Other Names 1

Doing Business AsKanawha City Health Center

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

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 of Waiver 51D2082231

Kanawha City Health Center · Charleston, WV
Expired · Aug 10, 2026
CLIA Number51D2082231
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 11, 2024
Certificate Expiration DateAugust 10, 2026
Laboratory DirectorDr. Brandon Merritt
Laboratory Phone(304) 205-7535
Laboratory LocationKanawha City Health Center4602 Maccorkle Avenue SE, Charleston, WV 25304
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

KANCHAN KATUWAL THAPA NP
Nurse Practitioner (Family)
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 205-7535
ABBEY RAE MOORE NP
Nurse Practitioner (Family)
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 205-7535
DR. KAITLIN MAY PSYD
Psychologist
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (681) 205-8600
INTEGRATED HEALTH CARE PROVIDERS, INC.
Emergency Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 925-4777
DR. RANDALL ALAN SWAIN MD
Family Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 925-4777
MR. PARRISH EDWARD HARLESS APRN, FNP-BC
Nurse Practitioner (Family)
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 205-7535
MRS. KAREN LYNN BAILEY PA-C
Physician Assistant
4602 MACCORKLE AVE SE, 81 LINCOLN PANTHER WAY
CHARLESTON, WV 25304
Kanawha County (304) 205-7535
DONALD L SEIDLER MD
Family Medicine
4602 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 925-4777

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 Cabin Creek Health Center, Inc.'s NPI number?

The NPI number for Cabin Creek Health Center, Inc. is 1588908362. It was assigned to this organization in the NPPES registry on November 19, 2012. The provider is doing business as Kanawha City Health Center.

Where is Cabin Creek Health Center, Inc. located?

Cabin Creek Health Center, Inc. is located at 4602 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 734-2040.

What is Cabin Creek Health 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.

What insurance does Cabin Creek Health Center, Inc. accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Cabin Creek Health Center, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Cabin Creek Health Center, Inc. was last updated on November 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.