Clinch Valley Nephrology Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

CLINCH VALLEY NEPHROLOGY INC

Doing business as

Richlands Express Dialysis Center

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

Last updated

Aug 22, 2020By the provider in NPPES

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, MDNPI 1770534042

Title

Ceo

Phone

(276) 964-4001

Specialties & licenses 1

Addresses

Other names 1

• Richlands Express Dialysis Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• In Young Park, MD

  • Internal Medicine Physician
  • Richlands, VA
  • NPI 1770534042
  Authorized official Same address or phone

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richlands Express Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clinch Valley Medical Center Inc (Clinch Valley Medical Center - Rehab Unit)
• Clinch Valley Medical Center Inc. (Clinch Valley Medical Center - SNF Unit)
• Clinch Valley Medical Center Inc. (Clinch Valley Medical Center)
• Clinch Valley Medical Center, Inc. (Preferred Home Health Services)
• Clinch Valley Medical Center, Inc. (Clinch Valley Medical Center - Swing Bed Unit)
• Clinch Valley Nephrology,Inc.
• Clinch Valley Physicians Associates LLC (Clinch Valley Physicians)
• Clinch Valley Physicians Associates LLC (Clinch Valley Physicians)
• Clinch Valley Physicians Associates LLC (Clinch Valley Physicians)
• 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.