Clinch Valley Nephrology Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

CLINCH VALLEY NEPHROLOGY INC

Practice address

2951 W Front Street
CVMP Suite B800
Richlands, VA 24641

Phone

(276) 964-4001

Fax

(276) 964-4003

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. In Young Park, MD

Title

Ceo

Phone

(276) 964-4001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Richlands Express Dialysis Center Doing business as

Locations

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154473296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 W FRONT STREET",
            "address_2": "CVMP SUITE 1600",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "24641",
            "telephone_number": "276-964-4001",
            "fax_number": "276-964-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 W FRONT STREET",
            "address_2": "CVMP SUITE B800",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "24641",
            "telephone_number": "276-964-4001",
            "fax_number": "276-964-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCH VALLEY NEPHROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "IN",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "276-964-4001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "442324",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richlands Express Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clinch Valley Medical Center Inc
• Clinch Valley Medical Center Inc.
• Clinch Valley Medical Center Inc.
• Clinch Valley Medical Center, Inc.
• Clinch Valley Medical Center, Inc.
• Clinch Valley Nephrology,Inc.
• Clinch Valley Physicians Associates LLC
• Clinch Valley Physicians Associates LLC
• Clinch Valley Physicians Associates LLC
• Clinch Valley Physicians Inc

• Nephrology Physician in Richlands, VA
• Providers in Richlands, VA by specialty
• Nephrology Physician in 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.