Express Care Clinic L.L.C.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

48923 Issued in WV

Legal business name

EXPRESS CARE CLINIC L.L.C.

Practice address

1455 Robert C Byrd Dr
Crab Orchard, WV 25827-9441

Phone

(304) 255-5533

Fax

(304) 929-5533

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Margaret Ann Blackburn, CFNP

Title

CFNP

Phone

(304) 255-5533

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Express Care Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Express Care Clinic, LLC

  • Primary Care Clinic/Center
  • Crab Orchard, WV
  • NPI 1114256799
  NPD tax ID

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114139722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 ROBERT C BYRD DR",
            "address_2": "P.O. BOX 755",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258279441",
            "telephone_number": "304-255-5533",
            "fax_number": "304-929-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 ROBERT C BYRD DR",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258279441",
            "telephone_number": "304-255-5533",
            "fax_number": "304-929-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS CARE CLINIC L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CFNP",
        "authorized_official_telephone_number": "304-255-5533",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WV",
            "license": "48923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104152000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Deane
• Stephanie Michelle Devaney
• Patricia Dixon
• Olen Jade Dodd, CRC
• Angela M Elkins, PA-C
• Express Care Clinic, LLC
• Brenda Hambric
• Angelia Dawn Harper, LSW
• Shannon Hughart, MA, CBIS
• L&M Medical Equipment, Inc

• Acute Care Nurse Practitioner in Crab Orchard, WV
• Providers in Crab Orchard, WV by specialty
• Acute Care Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.