Tabitha Rynn Clark, CNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

112519 Issued in WV

Practice address

519 G Road
Arthurdale, WV 26520

Phone

(304) 864-0884

NPI assigned

Apr 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tabitha Rynn Jeffries Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
• Preston Memorial Hospital Hospital, Kingwood, WV, CCN 511312
• Davis Medical Center Hospital, Elkins, WV, CCN 510030
• Grafton City Hospital, Inc Hospital, Grafton, WV, CCN 511307

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

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.

• Elitecare Express LLC

  • Primary Care Clinic/Center
  • Morgantown, WV
  • NPI 1134054836
  NPD Authorized official
• Hospice Care Corporation

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Arthurdale, WV
  • NPI 1316081128
  Medicare reassignment
• Hospice Care Corporation

  • Community Based Hospice Care Agency
  • Arthurdale, WV
  • NPI 1194722595
  NPD (past)
• Preston Health Care Services LLC

  • Family Health Clinical Nurse Specialist
  • Kingwood, WV
  • NPI 1811220643
  NPD (past)
• Capital Palliative Care Consultants, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Falls Church, VA
  • NPI 1275541013
  NPD (past)

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

• Davis Memorial Hospital

  • General Acute Care Hospital
  • Elkins, WV
  • NPI 1619964806
  Care Compare affiliation
• Grafton City Hospital Inc

  • Critical Access Hospital
  • Grafton, WV
  • NPI 1265484893
  Care Compare affiliation
• Preston Memorial Hospital Corporation

  • Critical Access Hospital
  • Kingwood, WV
  • NPI 1013950054
  Care Compare affiliation
• West Virginia University Hospitals, Inc

  • General Acute Care Hospital
  • Morgantown, WV
  • NPI 1841271459
  Care Compare affiliation

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1124762695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WILLIAMS ST",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 G ROAD",
            "city": "ARTHURDALE",
            "state": "WV",
            "postal_code": "26520",
            "telephone_number": "304-864-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TABITHA",
        "middle_name": "RYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "112519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "JEFFRIES",
            "middle_name": "RYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dawn Conrad
• Timothy Aaron Cordwell
• Hospice Care Corporation
• Hospice Care Corporation
• Hospice Care Corporation

• Primary Care Nurse Practitioner in Arthurdale, WV
• Providers in Arthurdale, WV by specialty
• Primary Care Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.