Individual provider Active NPI

Cassandra Lea Clayborne, MD

  • Family Medicine Physician
  • Harpers Ferry, WV
National Provider Identifier
1053999532
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34074 Issued in WV
Practice address
171 Taylor St
-
Harpers Ferry, WV 25425-3641
Phone
(304) 535-6343
Fax
(304) 535-6618
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34074 WV Primary

Addresses

Primary practice location

171 Taylor St
-
Harpers Ferry, WV 25425-3641

Mailing address

171 Taylor St
Harpers Ferry, WV 25425-3641
Phone (301) 535-6344

Other practice location 1

171 Taylor St
Harpers Ferry, WV 25425-3641
Phone (301) 535-6344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830003264 WV Practitioner - Family Practice 5294274429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

203 E 4TH Ave
Ranson, WV 25438-1617
Phone (304) 725-6343

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34074WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Family Medicine CurrentSince Aug 7, 2024 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 7, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

171 Taylor St
Harpers Ferry, WV 25425
Phone (304) 535-6343

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

203 E 4th Ave
Ranson, WV 25438
Phone (304) 535-6343

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1053999532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 TAYLOR ST",
            "city": "HARPERS FERRY",
            "state": "WV",
            "postal_code": "254253641",
            "telephone_number": "301-535-6344",
            "fax_number": "304-535-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 TAYLOR ST",
            "address_2": "-",
            "city": "HARPERS FERRY",
            "state": "WV",
            "postal_code": "254253641",
            "telephone_number": "304-535-6343",
            "fax_number": "304-535-6618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Taylor St",
            "address_purpose": "LOCATION",
            "city": "Harpers Ferry",
            "state": "WV",
            "postal_code": "254253641",
            "country_code": "US",
            "telephone_number": "301-535-6344",
            "fax_number": "304-535-6618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAYBORNE",
        "first_name": "CASSANDRA",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "34074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harpers Ferry, WV

Sources for this page

Verify at the official NPI Registry.