Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Wriston, PA-C

Individual provider Medical Physician Assistant · NPI 1609277201

Shane Wriston, PA-C is a Physician Assistant in Ivydale, West Virginia. Qualified in 2013, 13 years ago. Practices with Community Care of West Virginia, Inc, a 87-clinician group and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
13
Licensed in
WV
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

797 Clinic Dr
Ivydale, WV 25113-8263
Phone: (304) 286-4200
Fax: (304) 286-2107
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 01845 (WV)

Record details

NPI number1609277201
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 15, 2014
Last updated in NPPESAugust 31, 2022
Certification dateAugust 31, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Community Care Of West Virginia, Inc. — 87 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare