Individual provider Active NPI

Mackenzie James Clarkson, MD

  • Internal Medicine Physician
  • Fairmont, WV
National Provider Identifier
1073908034
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27820 Issued in WV
Practice address
1377 Locust Ave
Fairmont, WV 26554-1791
Phone
(304) 363-3500
Fax
(304) 366-4073
NPI assigned
Apr 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 27820 WV
Internal Medicine Physician 207R00000X 27820 WV Primary

Addresses

Primary practice location

1377 Locust Ave
Fairmont, WV 26554-1791

Mailing address

PO Box 9186
Morgantown, WV 26506-9186
Phone (304) 293-1224

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
I20190903001384 WV Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4789987322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
West Virginia University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

Practice addresses (Care Compare)

14 Comfort Dr
Reedsville, WV 26547-0359
Phone (304) 864-0006

Hospital & facility affiliations

  • Wvuhs Home Care Home health agency, Clarksburg, WV, CCN 517053
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Internal Medicine Current Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 2, 2019 Accepting new patients
Wvu Med Corp Cheat Lake Physicians CurrentSince Aug 2, 2019 Accepting new patients

Locations

1377 Locust Ave
Fairmont, WV 26554
Phone (304) 363-3500

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

1 Medical Center Dr
Rm 4601
Morgantown, WV 26506
Phone (304) 293-5323

14 Comfort Dr
Reedsville, WV 26547
Phone (304) 864-0006

Interoperability endpoints

  • Direct secure messaging: mclarkson25842@direct.wvuhsdirect.com

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 2

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": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1073908034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9186",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265069186",
            "telephone_number": "304-293-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541791",
            "telephone_number": "304-363-3500",
            "fax_number": "304-366-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "MACKENZIE",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "27820",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "27820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.