Davita of Greenbrier

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

030330 Issued in WV

Legal business name

DAVITA OF GREENBRIER

Practice address

129 Seneca TRL
Lewisburg, WV 24901-1564

Phone

(304) 645-4806

Fax

(304) 647-3941

NPI assigned

Sep 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marilyn Kelley, RN

Title

Facility Administrator

Phone

(304) 645-4806

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gambro Healthcare Former legal business name

Tax ID family

CDS of Zephyrhills194 organizations share this tax ID, including this one

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1003001215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 SENECA TRL",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011564",
            "telephone_number": "304-645-4806",
            "fax_number": "304-647-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 SENECA TRL",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011564",
            "telephone_number": "304-645-4806",
            "fax_number": "304-647-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA OF GREENBRIER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "304-645-4806",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "WV",
            "license": "030330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005742000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gambro Healthcare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Maegan Culp, DO
• Deloris Ann Dahmer
• Justin C Darby
• Pammi Das, MBBS
• Davis-Stuart, Inc.
• Patricia Lynn Deaver, GSW
• Izabella Lynn Defibaugh, RN
• Kimberly M Defibaugh
• Patricia Defibaugh
• Lisa Degraft

• Nursing Care Agency in Lewisburg, WV
• Providers in Lewisburg, WV by specialty
• Nursing Care Agency in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.