Individual provider Active NPI

Mary Elise McClintic, DPT

  • Physical Therapist
  • Ronceverte, WV
National Provider Identifier
1104171636
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT003057 Issued in WV
Practice address
111 Davis Stuart Rd
Ronceverte, WV 24970-9549
Phone
(304) 647-3987
Fax
(304) 647-3990
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003057 WV Primary

Addresses

Primary practice location

111 Davis Stuart Rd
Ronceverte, WV 24970-9549

Mailing address

111 Davis Stuart Rd
Ronceverte, WV 24970-9549
Phone (304) 647-3987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000685 WV Practitioner - Physical Therapist in Private Practice 6204082217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
West Virginia University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenbrier Valley Physical Therapy LLCGroup PAC ID 3870499957, 57 clinicians

Practice addresses (Care Compare)

2947 Jefferson St N
Suite 1
Lewisburg, WV 24901-5796
Phone (304) 645-2525

3942 Davis Stuart Rd
Suite 3
Ronceverte, WV 24970-0269
Phone (304) 647-3987

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
71.18
Promoting interoperability
92
Improvement activities
40
Cost
79.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT003057WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist CurrentSince Jul 20, 2012 Accepting new patients
Greenbrier Valley Physical Therapy LLC CurrentSince Jul 20, 2012 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist Current Accepting new patients

Locations

390 John Raine Dr
Rainelle, WV 25962
Phone (304) 438-9225

3942 Davis Stuart Rd
Ste 3
Ronceverte, WV 24970
Phone (304) 647-3987

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.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1104171636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DAVIS STUART RD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249709549",
            "telephone_number": "304-647-3987",
            "fax_number": "304-647-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DAVIS STUART RD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249709549",
            "telephone_number": "304-647-3987",
            "fax_number": "304-647-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTIC",
        "first_name": "MARY",
        "middle_name": "ELISE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT003057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.