Active NPI
Jill McClanahan Justice, M.D.
- Body Imaging Physician
- Huntington, WV
National Provider Identifier
1124044847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- 19305
- Practice address
- 1540 Spring Valley Dr
Huntington, WV 25704-9300 - Phone
- (304) 429-6755
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 19305 | WV | Primary |
Addresses
Primary practice location
1540 Spring Valley Dr
Huntington, WV 25704-9300
Mailing address
107 McClanahan Way
Poca, WV 25159-8980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19305 | WV | MD | Body Imaging Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124044847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 MCCLANAHAN WAY",
"city": "POCA",
"state": "WV",
"postal_code": "251598980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 SPRING VALLEY DR",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257049300",
"telephone_number": "304-429-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTICE",
"first_name": "JILL",
"middle_name": "MCCLANAHAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "WV",
"license": "19305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.